ReceivedClaimProcedureFact
The received claim procedure fact contains information about procedures from received institutional or professional claims. Columns contain information considered accurate by the payer, so the data is intended for cost and quality analytics. Each row represents a procedure reported on a received claim. Procedures are loaded from service lines on professional claims and from either service lines or the claim header on institutional claims.
For claims loaded from Clarity, columns can contain either data as received from the sender or as currently stored. Received information is used when there is no common workflow for the payer to change the received data. For example, received data is preferred for billing provider. Current data is preferred for information calculated by the payer, such as payment amounts, or when there is a valid workflow during which the payer might alter the received version of the claim, such as changing the diagnosis or procedure during code editing. Procedures from all received claims, except voided, reprice, and intermediate claims, are loaded, including unpaid claims.
Properties
- Reporting table name
- dbo.ReceivedClaimProcedureFact
- Granularity
- A procedure on a received claim
- Profile tables
- none
- Links to
- Links from
-
- AccumulationInstanceFact
- ApClaimActionFact
- ApClaimProcessingCodeAuditFact
- ManagedCareTransactionFact
- QdmAssessmentPerformedEventFact
- QdmDeviceAppliedEventFact
- QdmDiagnosisEventFact
- QdmDiagnosticStudyPerformedEventFact
- QdmImmunizationAdministeredEventFact
- QdmInterventionPerformedEventFact
- QdmLaboratoryTestPerformedEventFact
- QdmPhysicalExamPerformedEventFact
- QdmProcedurePerformedEventFact
- QdmSymptomEventFact
- QmEncounterClaimMappingFact
- ReceivedClaimAnalyticsDataMart
- ReceivedClaimProcedureAttributeValueDim
- ReceivedClaimProcedureBundleMappingFact
- ReceivedClaimReferralMappingFact
- ReceivedClaimResponsibilityClassFact
- UtilMgmtAuthReqSvcRcvClmProcMappingFact
- ValueBasedPaymentEventFact
- Snapshot on data change
- Disabled
Columns
ReceivedClaimProcedureKey
: integerSurrogate key used to uniquely identify the record
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
ReceivedClaimKey
: integerReceived claim associated with the procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReceivedClaimId |
|
||
| ReceivedClaimIdType |
"MsspClaimUniqueId" |
CMS ACO Part A Procedure Files Load
| ReceivedClaimId |
|
||
| ReceivedClaimIdType |
"MsspClaimUniqueId" |
CMS ACO Part B DME File Load
| ReceivedClaimId |
|
||
| ReceivedClaimIdType |
"MsspClaimUniqueId" |
CMS ACO Part B Physicians File Load
| ReceivedClaimId |
|
||
| ReceivedClaimIdType |
"MsspClaimUniqueId" |
CMS CJR DME Claim Procedure Load
| ReceivedClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||||||
| ReceivedClaimIdType |
CmsCjrUniqueClaimId |
CMS CJR Home Health Claim Procedure Load
| ReceivedClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||||||
| ReceivedClaimIdType |
CmsCjrUniqueClaimId |
CMS CJR Inpatient Claim Procedure Load
| ReceivedClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||||||
| ReceivedClaimIdType |
CmsCjrUniqueClaimId |
CMS CJR Outpatient Claim Procedure Load
| ReceivedClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||||||
| ReceivedClaimIdType |
CmsCjrUniqueClaimId |
CMS CJR Part B Claim Procedure Load
| ReceivedClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||||||
| ReceivedClaimIdType |
CmsCjrUniqueClaimId |
CMS CJR Skilled Nursing Claim Procedure Load
| ReceivedClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||||||
| ReceivedClaimIdType |
CmsCjrUniqueClaimId |
CMS CJR Surgical Procedure Load
| ReceivedClaimId |
|
||||||||||||||||||||||||||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
|||||||||||||||||||||||||||||||||
| ReceivedClaimIdType |
CmsCjrUniqueClaimId |
Data Aggregation ICD Procedure Load
| ReceivedClaimId |
|
||
|
AP_CLAIM_ICD_PROC.CLAIM_ID |
|||
| ReceivedClaimIdType |
"EpicExternallyPaidClaimDataAggId" |
Data Aggregation Service Line Load
| ReceivedClaimId |
|
||
| ReceivedClaimIdType |
"EpicExternallyPaidClaimDataAggId" |
Externally Adjudicated ICD Procedure Load
| ReceivedClaimId |
|
||
|
AP_CLAIM_ICD_PROC.CLAIM_ID |
|||
| ReceivedClaimIdType |
"EpicExternalPaidClaimInformationId" |
Externally Adjudicated Service Line Load
| ReceivedClaimId |
|
||||
| ReceivedClaimIdType |
"EpicExternalPaidClaimInformationId" |
Payer System ICD Procedure Load
| ReceivedClaimId |
|
||
|
AP_CLAIM_ICD_PROC.CLAIM_ID |
|||
| ReceivedClaimIdType |
"EpicExternalPaidPayerSystemClaimId" |
Payer System Service Line Load
| ReceivedClaimId |
|
||||
| ReceivedClaimIdType |
"EpicExternalPaidPayerSystemClaimId" |
Received Claim ICD Procedure Load
| ReceivedClaimId |
|
||
|
AP_CLAIM_ICD_PROC.CLAIM_ID |
|||
| ReceivedClaimIdType |
EpicClaimInformationId |
Received Claim Procedure Load
| ReceivedClaimId |
|
||||
| ReceivedClaimIdType |
"EpicClaimInformationId" |
PayerClaimId
: stringClaim Id as assigned by the payer
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| PayerClaimId |
|
||
CMS ACO Part A Procedure Files Load
| PayerClaimId |
|
||
CMS ACO Part B DME File Load
| PayerClaimId |
|
||
CMS ACO Part B Physicians File Load
| PayerClaimId |
|
||
CMS CJR DME Claim Procedure Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Home Health Claim Procedure Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Inpatient Claim Procedure Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Outpatient Claim Procedure Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Part B Claim Procedure Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Skilled Nursing Claim Procedure Load
| PayerClaimId |
|
||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
CMS CJR Surgical Procedure Load
| PayerClaimId |
|
||||||||||||||||||||||||||||||||
|
GEO_BENE_SK|CLM_DT_SGNTR_SK|CLM_TYPE_CD|CLM_NUM_SK |
Data Aggregation ICD Procedure Load
| PayerClaimId |
|
||
Data Aggregation Service Line Load
| PayerClaimId |
|
||
Externally Adjudicated ICD Procedure Load
| PayerClaimId |
|
||
|
CLM_VALUES.ICN |
Externally Adjudicated Service Line Load
| PayerClaimId |
|
||
|
CLM_VALUES.ICN |
Payer System ICD Procedure Load
| PayerClaimId |
|
||
Payer System Service Line Load
| PayerClaimId |
|
||
Received Claim ICD Procedure Load
| PayerClaimId |
|
||||||
|
If AP_CLAIM.WORKFLOW_C IN ( 4, 5 ) then AP_CLAIM.ACCT_NUM_WITH_VEN Otherwise AP_CLAIM.CLAIM_ID |
Received Claim Procedure Load
| PayerClaimId |
|
||||||
|
If AP_CLAIM.WORKFLOW_C IN ( 4, 5 ) then AP_CLAIM.ACCT_NUM_WITH_VEN Otherwise AP_CLAIM.CLAIM_ID |
OriginalClaimProcedureKey
: integerOriginal claim procedure in the adjustment sequence
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
CMS CJR Home Health Claim Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
CMS CJR Inpatient Claim Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
CMS CJR Outpatient Claim Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
CMS CJR Part B Claim Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
CMS CJR Skilled Nursing Claim Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
CMS CJR Surgical Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
Data Aggregation ICD Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
Data Aggregation Service Line Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
Externally Adjudicated ICD Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
Externally Adjudicated Service Line Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
Payer System ICD Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
Payer System Service Line Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
Received Claim ICD Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
Received Claim Procedure Load
| OriginalClaimProcedureId |
NULL |
| OriginalClaimProcedureIdType |
"NotApplicable" |
AdjustmentToClaimProcedureKey
: integerPrevious claim procedure to which this claim procedure is an adjustment
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Home Health Claim Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Inpatient Claim Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Outpatient Claim Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Part B Claim Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Skilled Nursing Claim Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Surgical Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
Data Aggregation ICD Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
NotApplicable |
Data Aggregation Service Line Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
Externally Adjudicated ICD Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
Payer System ICD Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
NotApplicable |
Payer System Service Line Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
Received Claim ICD Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
NotApplicable |
Received Claim Procedure Load
| AdjustmentToClaimProcedureId |
NULL |
| AdjustmentToClaimProcedureIdType |
"NotApplicable" |
ReversalToClaimProcedureKey
: integerPrevious claim procedure to which this claim procedure is a reversal
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Home Health Claim Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Inpatient Claim Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Outpatient Claim Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Part B Claim Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Skilled Nursing Claim Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
CMS CJR Surgical Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
Data Aggregation ICD Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
NotApplicable |
Data Aggregation Service Line Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
Externally Adjudicated ICD Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
Payer System ICD Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
NotApplicable |
Payer System Service Line Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
Received Claim ICD Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
NotApplicable |
Received Claim Procedure Load
| ReversalToClaimProcedureId |
NULL |
| ReversalToClaimProcedureIdType |
"NotApplicable" |
AdjustedByClaimProcedureKey
: integerClaim procedure which adjusts this procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Home Health Claim Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Inpatient Claim Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Outpatient Claim Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Part B Claim Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Skilled Nursing Claim Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Surgical Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
Data Aggregation ICD Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
NotApplicable |
Data Aggregation Service Line Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
Externally Adjudicated ICD Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
Payer System ICD Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
NotApplicable |
Payer System Service Line Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
Received Claim ICD Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
NotApplicable |
Received Claim Procedure Load
| AdjustedByClaimProcedureId |
NULL |
| AdjustedByClaimProcedureIdType |
"NotApplicable" |
ReversedByClaimProcedureKey
: integerClaim procedure which reversed this procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Home Health Claim Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Inpatient Claim Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Outpatient Claim Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Part B Claim Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Skilled Nursing Claim Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
CMS CJR Surgical Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
Data Aggregation ICD Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
NotApplicable |
Data Aggregation Service Line Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
Externally Adjudicated ICD Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
Payer System ICD Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
NotApplicable |
Payer System Service Line Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
Received Claim ICD Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
NotApplicable |
Received Claim Procedure Load
| ReversedByClaimProcedureId |
NULL |
| ReversedByClaimProcedureIdType |
"NotApplicable" |
PatientKey
: integerPatient associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part A Procedure Files Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PerformedStartDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
CMS ACO Part B DME File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part B Physicians File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PerformedStartDate |
|
||
CMS CJR Home Health Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PerformedStartDate |
|
||
CMS CJR Inpatient Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PerformedStartDate |
|
||
CMS CJR Outpatient Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PerformedStartDate |
|
||
CMS CJR Part B Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PerformedStartDate |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PerformedStartDate |
|
||
CMS CJR Surgical Procedure Load
| PatientId |
|
||||||||
| PatientIdType |
IdrBeneficiaryKey |
||||||||
| PerformedStartDate |
|
||||||||
Data Aggregation ICD Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PerformedStartDate |
|
||||
Data Aggregation Service Line Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PerformedStartDate |
|
||||
|
Time Zone: Unspecified |
Externally Adjudicated ICD Procedure Load
| PatientId |
|
||||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||||
| PatientIdType |
|
||||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||||
| PerformedStartDate |
|
||||||
Externally Adjudicated Service Line Load
| PatientId |
|
||||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||||
| PatientIdType |
|
||||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||||
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
Payer System ICD Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PerformedStartDate |
|
||||
Payer System Service Line Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PerformedStartDate |
|
||||
|
Time Zone: Unspecified |
Received Claim ICD Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PerformedStartDate |
|
||||
Received Claim Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PerformedStartDate |
|
||||
|
Time Zone: Unspecified |
PatientDurableKey
: integerPatient associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
CMS ACO Part A Procedure Files Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
CMS ACO Part B DME File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
CMS ACO Part B Physicians File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
CMS CJR DME Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Home Health Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Inpatient Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Outpatient Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Part B Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Skilled Nursing Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
CMS CJR Surgical Procedure Load
| PatientId |
|
||||||||
| PatientIdType |
IdrBeneficiaryKey |
Data Aggregation ICD Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Data Aggregation Service Line Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Externally Adjudicated ICD Procedure Load
| PatientId |
|
||||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||||
| PatientIdType |
|
||||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Externally Adjudicated Service Line Load
| PatientId |
|
||||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||||
| PatientIdType |
|
||||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Payer System ICD Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Payer System Service Line Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Received Claim ICD Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
Received Claim Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
PatientSourceDataDurableKey
: integerPatient associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PatientSourceName |
NULL (use source of the package) |
CMS ACO Part A Procedure Files Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PatientSourceName |
NULL (use source of the package) |
CMS ACO Part B DME File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PatientSourceName |
NULL (use source of the package) |
CMS ACO Part B Physicians File Load
| PatientId |
|
||
|
The preferred id will be used from "BENE_HIC_NUM" if populated; otherwise the fallback id will be used from "MBI" |
|||
| PatientIdType |
The preferred id type "EpicPatientHicn" if the column "BENE_HIC_NUM" is populated Otherwise "EpicPatientMbi" will be used with the value from the column "MBI" |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR DME Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Home Health Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Inpatient Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Outpatient Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Part B Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Skilled Nursing Claim Procedure Load
| PatientId |
|
||
| PatientIdType |
IdrBeneficiaryKey |
||
| PatientSourceName |
NULL (use source of the package) |
CMS CJR Surgical Procedure Load
| PatientId |
|
||||||||
| PatientIdType |
IdrBeneficiaryKey |
||||||||
| PatientSourceName |
NULL (use source of the package) |
Data Aggregation ICD Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
NULL (use source of the package) |
Data Aggregation Service Line Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
NULL (use source of the package) |
Externally Adjudicated ICD Procedure Load
| PatientId |
|
||||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||||
| PatientIdType |
|
||||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||||
| PatientSourceName |
NULL (use source of the package) |
Externally Adjudicated Service Line Load
| PatientId |
|
||||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||||
| PatientIdType |
|
||||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||||
| PatientSourceName |
NULL (use source of the package) |
Payer System ICD Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
NULL (use source of the package) |
Payer System Service Line Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
NULL (use source of the package) |
Received Claim ICD Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
NULL (use source of the package) |
Received Claim Procedure Load
| PatientId |
|
||||
|
If PAT_ID is NULL then IDENT_BUNDLE_ID Otherwise PAT_ID |
|||||
| PatientIdType |
|
||||
|
If PAT_ID is NULL then "EpicExternalIDBundleID" Otherwise "EpicPatientId" |
|||||
| PatientSourceName |
NULL (use source of the package) |
PrimaryCoverageKey
: integerPrimary coverage associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PrimaryCoverageId |
|
||
|
If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable" |
CMS ACO Part A Procedure Files Load
| PrimaryCoverageId |
|
||
|
If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable" |
CMS ACO Part B DME File Load
| PrimaryCoverageId |
|
||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable" |
CMS ACO Part B Physicians File Load
| PrimaryCoverageId |
|
||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId component configuration for ReceivedClaimFact Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "EpicPayorId" Otherwise "NotApplicable" |
CMS CJR DME Claim Procedure Load
| PrimaryCoverageId |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then CmsPayorEpicId Otherwise NotApplicable |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then EpicPayorId Otherwise NotApplicable |
CMS CJR Home Health Claim Procedure Load
| PrimaryCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| PrimaryCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| PrimaryCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable |
CMS CJR Part B Claim Procedure Load
| PrimaryCoverageId |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then CmsPayorEpicId Otherwise NotApplicable |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then EpicPayorId Otherwise NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| PrimaryCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL |
|||
| PrimaryCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable |
CMS CJR Surgical Procedure Load
| PrimaryCoverageId |
|
||||||||
|
If claim is inpatient, skilled nursing, or hospice: If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then CmsPayorEpicId Otherwise NULL Otherwise if claim is Part B: If PRPAYAMT is NULL or PRPAYAMT = 0 then CmsPayorEpicId Otherwise NotApplicable |
|||||||||
| PrimaryCoverageIdType |
|
||||||||
|
If claim is inpatient, skilled nursing, or hospice: If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then EpicPayorId Otherwise NotApplicable Otherwise if claim is Part B: If PRPAYAMT is NULL or PRPAYAMT = 0 then EpicPayorId Otherwise NotApplicable |
Data Aggregation ICD Procedure Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
|
||
|
If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Data Aggregation Service Line Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
|
||
|
If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Externally Adjudicated ICD Procedure Load
| PrimaryCoverageId |
|
||
|
AP_CLAIM_3.PRIM_PAYOR_ID |
|||
| PrimaryCoverageIdType |
|
||
|
If AP_CLAIM_3.PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Externally Adjudicated Service Line Load
| PrimaryCoverageId |
|
||
|
AP_CLAIM_3.PRIM_PAYOR_ID |
|||
| PrimaryCoverageIdType |
|
||
|
If AP_CLAIM_3.PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Payer System ICD Procedure Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
|
||
|
If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Payer System Service Line Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
|
||
|
If PRIM_PAYOR_ID is not NULL then "EpicPayorId" Otherwise "NotApplicable" |
Received Claim ICD Procedure Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
EpicCoverageId |
Received Claim Procedure Load
| PrimaryCoverageId |
|
||
| PrimaryCoverageIdType |
"EpicCoverageId" |
SecondCoverageKey
: integerSecond coverage associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| SecondCoverageId |
|
||
|
If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact |
|||
| SecondCoverageIdType |
|
||
|
If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId" |
CMS ACO Part A Procedure Files Load
| SecondCoverageId |
|
||
|
If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact |
|||
| SecondCoverageIdType |
|
||
|
If CLM_NCH_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId" |
CMS ACO Part B DME File Load
| SecondCoverageId |
|
||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact |
|||
| SecondCoverageIdType |
|
||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId" |
CMS ACO Part B Physicians File Load
| SecondCoverageId |
|
||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId component configuration for ReceivedClaimFact |
|||
| SecondCoverageIdType |
|
||
|
If CLM_PRMRY_PYR_CD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then "NotApplicable" Otherwise "EpicPayorId" |
CMS CJR DME Claim Procedure Load
| SecondCoverageId |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then NotApplicable Otherwise EpicPayorId |
CMS CJR Home Health Claim Procedure Load
| SecondCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId |
CMS CJR Inpatient Claim Procedure Load
| SecondCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId |
CMS CJR Outpatient Claim Procedure Load
| SecondCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId |
CMS CJR Part B Claim Procedure Load
| SecondCoverageId |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYAMT is NULL or PRPAYAMT = 0 then NotApplicable Otherwise EpicPayorId |
CMS CJR Skilled Nursing Claim Procedure Load
| SecondCoverageId |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NULL Otherwise CmsPayorEpicId |
|||
| SecondCoverageIdType |
|
||
|
If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId |
CMS CJR Surgical Procedure Load
| SecondCoverageId |
|
||||||||
|
If claim is inpatient, skilled nursing, or hospice: If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId Otherwise if claim is Part B: If PRPAYAMT is NULL or PRPAYAMT = 0 then NULL Otherwise CmsPayorEpicId |
|||||||||
| SecondCoverageIdType |
|
||||||||
|
If claim is inpatient, skilled nursing, or hospice: If PRPAYCD = NULL-Medicare is primary payer, C-Conditional payment by Medicare; future reimbursement expected, M-Override Code: EGHP services involved, N-Override Code: non-EGHP services involved, Y-Other secondary payer investigation shows Medicare as primary payer, or Z-Medicare is primary payer then NotApplicable Otherwise EpicPayorId Otherwise if claim is Part B: If PRPAYAMT is NULL or PRPAYAMT = 0 then NotApplicable Otherwise EpicPayorId |
Data Aggregation ICD Procedure Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
NotApplicable |
Data Aggregation Service Line Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
"NotApplicable" |
Externally Adjudicated ICD Procedure Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
"NotApplicable" |
Payer System ICD Procedure Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
NotApplicable |
Payer System Service Line Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
"NotApplicable" |
Received Claim ICD Procedure Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
NotApplicable |
Received Claim Procedure Load
| SecondCoverageId |
NULL |
| SecondCoverageIdType |
"NotApplicable" |
ThirdCoverageKey
: integerThird coverage associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
CMS CJR Surgical Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
Data Aggregation Service Line Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
Externally Adjudicated ICD Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
Payer System ICD Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
Payer System Service Line Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
Received Claim ICD Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
NotApplicable |
Received Claim Procedure Load
| ThirdCoverageId |
NULL |
| ThirdCoverageIdType |
"NotApplicable" |
PlaceOfServiceKey
: integerPlace of service associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
"FacilityNpi" |
CMS ACO Part A Procedure Files Load
| PlaceOfServiceId |
NULL |
| PlaceOfServiceIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| PlaceOfServiceId |
NULL |
| PlaceOfServiceIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| PlaceOfServiceId |
NULL |
| PlaceOfServiceIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| PlaceOfServiceId |
NULL |
| PlaceOfServiceIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
FacilityNpi |
CMS CJR Inpatient Claim Procedure Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
FacilityCcn |
CMS CJR Outpatient Claim Procedure Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
FacilityCcn |
CMS CJR Part B Claim Procedure Load
| PlaceOfServiceId |
NULL |
| PlaceOfServiceIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| PlaceOfServiceId |
|
||
| PlaceOfServiceIdType |
FacilityCcn |
CMS CJR Surgical Procedure Load
| PlaceOfServiceId |
|
||||||
|
If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL |
|||||||
| PlaceOfServiceIdType |
If claim is inpatient, skilled nursing, or hospice then FacilityCcn Otherwise NotApplicable |
Data Aggregation ICD Procedure Load
| PlaceOfServiceId |
|
||||
|
If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI |
|||||
| PlaceOfServiceIdType |
|
||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Data Aggregation Service Line Load
| PlaceOfServiceId |
|
||||||
|
If LOC_ID is not NULL then LOC_ID Otherwise if LN_SVC_FAC_NPI is not NULL and the number of services has not been modified in the system then LN_SVC_FAC_NPI Otherwise SVC_FAC_NPI |
|||||||
| PlaceOfServiceIdType |
|
||||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Externally Adjudicated ICD Procedure Load
| PlaceOfServiceId |
|
||||
|
If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI |
|||||
| PlaceOfServiceIdType |
|
||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Externally Adjudicated Service Line Load
| PlaceOfServiceId |
|
||||||
|
If LOC_ID is not NULL then LOC_ID Otherwise if LN_SVC_FAC_NPI is not NULL then LN_SVC_FAC_NPI Otherwise SVC_FAC_NPI |
|||||||
| PlaceOfServiceIdType |
|
||||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Payer System ICD Procedure Load
| PlaceOfServiceId |
|
||||
|
If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI |
|||||
| PlaceOfServiceIdType |
|
||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Payer System Service Line Load
| PlaceOfServiceId |
|
||||||
|
If LOC_ID is not NULL then LOC_ID Otherwise if LN_SVC_FAC_NPI is not NULL and the number of services has not been modified in the system then LN_SVC_FAC_NPI Otherwise SVC_FAC_NPI |
|||||||
| PlaceOfServiceIdType |
|
||||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Received Claim ICD Procedure Load
| PlaceOfServiceId |
|
||||
|
If LOC_ID is not NULL then LOC_ID Otherwise SVC_FAC_NPI |
|||||
| PlaceOfServiceIdType |
|
||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
Received Claim Procedure Load
| PlaceOfServiceId |
|
||||||||||||
|
If LOC_ID is not NULL then LOC_ID Otherwise if LN_SVC_FAC_NPI is not NULL and the number of services has not been modified in the system then LN_SVC_FAC_NPI Otherwise SVC_FAC_NPI |
|||||||||||||
| PlaceOfServiceIdType |
|
||||||||||||
|
If LOC_ID is not NULL then "EpicFacilityProfileId" Otherwise "FacilityNpi" |
CcnPlaceOfServiceKey
: integerPlace of service associated with the claim Centers for Medicare and Medicaid Services Certification Number (CCN)
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
"FacilityCcn" |
CMS ACO Part A Procedure Files Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
"FacilityCcn" |
CMS ACO Part B DME File Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
FacilityCcn |
CMS CJR Inpatient Claim Procedure Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
FacilityCcn |
CMS CJR Outpatient Claim Procedure Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
FacilityCcn |
CMS CJR Part B Claim Procedure Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| CcnPlaceOfServiceId |
|
||
| CcnPlaceOfServiceIdType |
FacilityCcn |
CMS CJR Surgical Procedure Load
| CcnPlaceOfServiceId |
|
||||||
|
If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL |
|||||||
| CcnPlaceOfServiceIdType |
If claim is inpatient, skilled nursing, or hospice then FacilityCcn Otherwise NotApplicable |
Data Aggregation ICD Procedure Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
Unspecified |
Data Aggregation Service Line Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"Unspecified" |
Externally Adjudicated ICD Procedure Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
Unspecified |
Externally Adjudicated Service Line Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"Unspecified" |
Payer System ICD Procedure Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
Unspecified |
Payer System Service Line Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"Unspecified" |
Received Claim ICD Procedure Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
Unspecified |
Received Claim Procedure Load
| CcnPlaceOfServiceId |
NULL |
| CcnPlaceOfServiceIdType |
"Unspecified" |
BillingProviderKey
: integerBilling provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part A Procedure Files Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
CMS ACO Part B DME File Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part B Physicians File Load
| BillingProviderId |
NULL |
||
| BillingProviderIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Procedure Load
| BillingProviderId |
NULL |
||
| BillingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Home Health Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
EpicProviderNpi |
||
| PerformedStartDate |
|
||
CMS CJR Inpatient Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| PerformedStartDate |
|
||
CMS CJR Outpatient Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| PerformedStartDate |
|
||
CMS CJR Part B Claim Procedure Load
| BillingProviderId |
NULL |
||
| BillingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| PerformedStartDate |
|
||
CMS CJR Surgical Procedure Load
| BillingProviderId |
|
||||||
|
If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL |
|||||||
| BillingProviderIdType |
If claim is inpatient, skilled nursing, or hospice then FacilityCcn Otherwise NotApplicable |
||||||
| PerformedStartDate |
|
||||||
Data Aggregation ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| PerformedStartDate |
|
||||||||||
Data Aggregation Service Line Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
|
||||||||||
|
"EpicProviderNpi" |
|||||||||||
| PerformedStartDate |
|
||||||||||
|
Time Zone: Unspecified |
Externally Adjudicated ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| PerformedStartDate |
|
||||||||||
Externally Adjudicated Service Line Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| PerformedStartDate |
|
||||||||||
|
Time Zone: Unspecified |
Payer System ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| PerformedStartDate |
|
||||||||||
Payer System Service Line Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| PerformedStartDate |
|
||||||||||
|
Time Zone: Unspecified |
Received Claim ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| PerformedStartDate |
|
||||||||||
Received Claim Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| PerformedStartDate |
|
||||||||||
|
Time Zone: Unspecified |
BillingProviderDurableKey
: integerBilling provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part A Procedure Files Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part B DME File Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part B Physicians File Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
EpicProviderNpi |
CMS CJR Inpatient Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
CMS CJR Outpatient Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
CMS CJR Part B Claim Procedure Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
CMS CJR Surgical Procedure Load
| BillingProviderId |
|
||||||
|
If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL |
|||||||
| BillingProviderIdType |
If claim is inpatient, skilled nursing, or hospice then FacilityCcn Otherwise NotApplicable |
Data Aggregation ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
Data Aggregation Service Line Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
|
||||||||||
|
"EpicProviderNpi" |
Externally Adjudicated ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
Externally Adjudicated Service Line Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
Payer System ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
Payer System Service Line Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
Received Claim ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
Received Claim Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
BillingProviderSourceDataDurableKey
: integerBilling provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
||
| BillingProviderSourceName |
"NPPES" |
CMS ACO Part A Procedure Files Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
||
| BillingProviderSourceName |
"NPPES" |
CMS ACO Part B DME File Load
| BillingProviderId |
|
||
| BillingProviderIdType |
"EpicProviderNpi" |
||
| BillingProviderSourceName |
"NPPES" |
CMS ACO Part B Physicians File Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
"NotApplicable" |
| BillingProviderSourceName |
NULL |
CMS CJR DME Claim Procedure Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
NotApplicable |
| BillingProviderSourceName |
NULL |
CMS CJR Home Health Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
EpicProviderNpi |
||
| BillingProviderSourceName |
"NPPES" |
CMS CJR Inpatient Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| BillingProviderSourceName |
"CMS" |
CMS CJR Outpatient Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| BillingProviderSourceName |
"CMS" |
CMS CJR Part B Claim Procedure Load
| BillingProviderId |
NULL |
| BillingProviderIdType |
NotApplicable |
| BillingProviderSourceName |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| BillingProviderId |
|
||
| BillingProviderIdType |
FacilityCcn |
||
| BillingProviderSourceName |
"CMS" |
CMS CJR Surgical Procedure Load
| BillingProviderId |
|
||||||
|
If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL |
|||||||
| BillingProviderIdType |
If claim is inpatient, skilled nursing, or hospice then FacilityCcn Otherwise NotApplicable |
||||||
| BillingProviderSourceName |
"CMS" |
Data Aggregation ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| BillingProviderSourceName |
"NPPES" |
Data Aggregation Service Line Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
|
||||||||||
|
"EpicProviderNpi" |
|||||||||||
| BillingProviderSourceName |
"NPPES" |
Externally Adjudicated ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| BillingProviderSourceName |
"NPPES" |
Externally Adjudicated Service Line Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| BillingProviderSourceName |
"NPPES" |
Payer System ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| BillingProviderSourceName |
"NPPES" |
Payer System Service Line Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| BillingProviderSourceName |
"NPPES" |
Received Claim ICD Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| BillingProviderSourceName |
"NPPES" |
Received Claim Procedure Load
| BillingProviderId |
|
||||||||||
| BillingProviderIdType |
"EpicProviderNpi" |
||||||||||
| BillingProviderSourceName |
"NPPES" |
ReferringProviderKey
: integerReferring provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
|||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| PerformedStartDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
|||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
|||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
|||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| PerformedStartDate |
|
||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| PerformedStartDate |
|
||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| PerformedStartDate |
|
||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| PerformedStartDate |
|
||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| PerformedStartDate |
|
||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| PerformedStartDate |
|
||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
CMS CJR Surgical Procedure Load
| PerformedStartDate |
|
||
| ReferringProviderId |
NULL |
||
| ReferringProviderIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| PerformedStartDate |
|
||||
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Data Aggregation Service Line Load
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
|||||||
| ReferringProviderId |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||
| ReferringProviderIdType |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated ICD Procedure Load
| PerformedStartDate |
|
||||
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated Service Line Load
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
|||||||
| ReferringProviderId |
|
||||||
|
If LN_REF_NPI is not NULL then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||
| ReferringProviderIdType |
|
||||||
|
If LN_REF_NPI is not NULL or REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System ICD Procedure Load
| PerformedStartDate |
|
||||
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System Service Line Load
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
|||||||
| ReferringProviderId |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||
| ReferringProviderIdType |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Claim ICD Procedure Load
| PerformedStartDate |
|
||||
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Claim Procedure Load
| PerformedStartDate |
|
||||||||||||
|
Time Zone: Unspecified |
|||||||||||||
| ReferringProviderId |
|
||||||||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||||||||
| ReferringProviderIdType |
|
||||||||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
ReferringProviderDurableKey
: integerReferring provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
CMS CJR Surgical Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Data Aggregation Service Line Load
| ReferringProviderId |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||
| ReferringProviderIdType |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated ICD Procedure Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated Service Line Load
| ReferringProviderId |
|
||||||
|
If LN_REF_NPI is not NULL then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||
| ReferringProviderIdType |
|
||||||
|
If LN_REF_NPI is not NULL or REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System ICD Procedure Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System Service Line Load
| ReferringProviderId |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||
| ReferringProviderIdType |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Claim ICD Procedure Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Claim Procedure Load
| ReferringProviderId |
|
||||||||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||||||||
| ReferringProviderIdType |
|
||||||||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
ReferringProviderSourceDataDurableKey
: integerReferring provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
NULL |
CMS ACO Part A Procedure Files Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
NULL |
CMS ACO Part B DME File Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
"NotApplicable" |
| ReferringProviderSourceName |
NULL |
CMS CJR DME Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Home Health Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Inpatient Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Outpatient Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Part B Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
CMS CJR Surgical Procedure Load
| ReferringProviderId |
NULL |
| ReferringProviderIdType |
NotApplicable |
| ReferringProviderSourceName |
NULL |
Data Aggregation ICD Procedure Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| ReferringProviderSourceName |
|
||||
|
If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Data Aggregation Service Line Load
| ReferringProviderId |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||
| ReferringProviderIdType |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| ReferringProviderSourceName |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated ICD Procedure Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| ReferringProviderSourceName |
|
||||
|
If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated Service Line Load
| ReferringProviderId |
|
||||||
|
If LN_REF_NPI is not NULL then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||
| ReferringProviderIdType |
|
||||||
|
If LN_REF_NPI is not NULL or REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| ReferringProviderSourceName |
|
||||||
|
If REF_PROV_NPI is not NULL or LN_REF_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System ICD Procedure Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| ReferringProviderSourceName |
|
||||
|
If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System Service Line Load
| ReferringProviderId |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||
| ReferringProviderIdType |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| ReferringProviderSourceName |
|
||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Claim ICD Procedure Load
| ReferringProviderId |
|
||||
|
If REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||
| ReferringProviderIdType |
|
||||
|
If REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| ReferringProviderSourceName |
|
||||
|
If REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Claim Procedure Load
| ReferringProviderId |
|
||||||||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then LN_REF_NPI Otherwise if REF_PROV_NPI is not NULL then REF_PROV_NPI Otherwise REF_PROV_ID |
|||||||||||||
| ReferringProviderIdType |
|
||||||||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REF_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||||||||
| ReferringProviderSourceName |
|
||||||||||||
|
If LN_REF_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REF_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
RenderingProviderKey
: integerRendering provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
|||
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| PerformedStartDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
|||
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
|||
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
|||
| RenderingProviderId |
|
||
| RenderingProviderIdType |
"EpicProviderNpi" |
CMS CJR DME Claim Procedure Load
| PerformedStartDate |
|
||
| RenderingProviderId |
|
||
| RenderingProviderIdType |
EpicProviderNpi |
CMS CJR Home Health Claim Procedure Load
| PerformedStartDate |
|
||
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| PerformedStartDate |
|
||
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| PerformedStartDate |
|
||
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| PerformedStartDate |
|
||
| RenderingProviderId |
|
||
| RenderingProviderIdType |
EpicProviderNpi |
CMS CJR Skilled Nursing Claim Procedure Load
| PerformedStartDate |
|
||
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
CMS CJR Surgical Procedure Load
| PerformedStartDate |
|
||
| RenderingProviderId |
NULL |
||
| RenderingProviderIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| PerformedStartDate |
|
||||||||||||||
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Data Aggregation Service Line Load
| PerformedStartDate |
|
||||||||||||||||||||||
|
Time Zone: Unspecified |
|||||||||||||||||||||||
| RenderingProviderId |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Externally Adjudicated ICD Procedure Load
| PerformedStartDate |
|
||||||||||||||
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Externally Adjudicated Service Line Load
| PerformedStartDate |
|
||||||||||||||||
|
Time Zone: Unspecified |
|||||||||||||||||
| RenderingProviderId |
|
||||||||||||||||
|
If LN_REND_NPI is not NULL then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||
|
If LN_REND_NPI is not NULL then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Payer System ICD Procedure Load
| PerformedStartDate |
|
||||||||||||||
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Payer System Service Line Load
| PerformedStartDate |
|
||||||||||||||||||||||
|
Time Zone: Unspecified |
|||||||||||||||||||||||
| RenderingProviderId |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Received Claim ICD Procedure Load
| PerformedStartDate |
|
||||||||||||||
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Received Claim Procedure Load
| PerformedStartDate |
|
||||||||||||||||||||||
|
Time Zone: Unspecified |
|||||||||||||||||||||||
| RenderingProviderId |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
RenderingProviderDurableKey
: integerRendering provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderId |
|
||
| RenderingProviderIdType |
"EpicProviderNpi" |
CMS CJR DME Claim Procedure Load
| RenderingProviderId |
|
||
| RenderingProviderIdType |
EpicProviderNpi |
CMS CJR Home Health Claim Procedure Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| RenderingProviderId |
|
||
| RenderingProviderIdType |
EpicProviderNpi |
CMS CJR Skilled Nursing Claim Procedure Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
CMS CJR Surgical Procedure Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Data Aggregation Service Line Load
| RenderingProviderId |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Externally Adjudicated ICD Procedure Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Externally Adjudicated Service Line Load
| RenderingProviderId |
|
||||||||||||||||
|
If LN_REND_NPI is not NULL then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||
|
If LN_REND_NPI is not NULL then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Payer System ICD Procedure Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Payer System Service Line Load
| RenderingProviderId |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Received Claim ICD Procedure Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
Received Claim Procedure Load
| RenderingProviderId |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
RenderingProviderSourceDataDurableKey
: integerRendering provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
NULL |
CMS ACO Part A Procedure Files Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
NULL |
CMS ACO Part B DME File Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
"NotApplicable" |
| RenderingProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| RenderingProviderId |
|
||
| RenderingProviderIdType |
"EpicProviderNpi" |
||
| RenderingProviderSourceName |
"NPPES" |
CMS CJR DME Claim Procedure Load
| RenderingProviderId |
|
||
| RenderingProviderIdType |
EpicProviderNpi |
||
| RenderingProviderSourceName |
"NPPES" |
CMS CJR Home Health Claim Procedure Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
CMS CJR Inpatient Claim Procedure Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
CMS CJR Outpatient Claim Procedure Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
CMS CJR Part B Claim Procedure Load
| RenderingProviderId |
|
||
| RenderingProviderIdType |
EpicProviderNpi |
||
| RenderingProviderSourceName |
"NPPES" |
CMS CJR Skilled Nursing Claim Procedure Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
CMS CJR Surgical Procedure Load
| RenderingProviderId |
NULL |
| RenderingProviderIdType |
NotApplicable |
| RenderingProviderSourceName |
NULL |
Data Aggregation ICD Procedure Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Data Aggregation Service Line Load
| RenderingProviderId |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Externally Adjudicated ICD Procedure Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Externally Adjudicated Service Line Load
| RenderingProviderId |
|
||||||||||||||||
|
If LN_REND_NPI is not NULL then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||
|
If LN_REND_NPI is not NULL then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||||
|
If REND_PROV_NPI is not NULL then "NPPES" Otherwise if LN_REND_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Payer System ICD Procedure Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Payer System Service Line Load
| RenderingProviderId |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Received Claim ICD Procedure Load
| RenderingProviderId |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI |
|||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||
|
If REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
Received Claim Procedure Load
| RenderingProviderId |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then LN_REND_NPI Otherwise if REND_PROV_NPI is not NULL then REND_PROV_NPI Otherwise if RENDERING_PROV_ID is not NULL then RENDERING_PROV_ID Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_NPI Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_NPI Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then PROV_ID |
|||||||||||||||||||||||
| RenderingProviderIdType |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if REND_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if RENDERING_PROV_ID is not NULL then "EpicProviderId" Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then "EpicProviderId" Otherwise "EpicProviderNpi" |
|||||||||||||||||||||||
| RenderingProviderSourceName |
|
||||||||||||||||||||||
|
If LN_REND_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if REND_PROV_NPI is not NULL then "NPPES" Otherwise if RENDERING_PROV_ID is not NULL then NULL (use source of the package) Otherwise if CLAIM_FORMAT_C = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and BIL_PROV_NPI is not NULL then "NPPES" Otherwise if CLAIM_FORMAT_C = 1 and PROV_ID is not NULL then NULL (use source of the package) Otherwise "NPPES" |
AttendingProviderKey
: integerAttending provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part A Procedure Files Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
CMS ACO Part B DME File Load
| AttendingProviderId |
NULL |
||
| AttendingProviderIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part B Physicians File Load
| AttendingProviderId |
NULL |
||
| AttendingProviderIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Procedure Load
| AttendingProviderId |
NULL |
||
| AttendingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Home Health Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| PerformedStartDate |
|
||
CMS CJR Inpatient Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| PerformedStartDate |
|
||
CMS CJR Outpatient Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| PerformedStartDate |
|
||
CMS CJR Part B Claim Procedure Load
| AttendingProviderId |
NULL |
||
| AttendingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| PerformedStartDate |
|
||
CMS CJR Surgical Procedure Load
| AttendingProviderId |
|
||||
|
If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL |
|||||
| AttendingProviderIdType |
If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable |
||||
| PerformedStartDate |
|
||||
Data Aggregation ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Data Aggregation Service Line Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| PerformedStartDate |
|
||||
|
Time Zone: Unspecified |
Externally Adjudicated ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Externally Adjudicated Service Line Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| PerformedStartDate |
|
||||
|
Time Zone: Unspecified |
Payer System ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Payer System Service Line Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| PerformedStartDate |
|
||||
|
Time Zone: Unspecified |
Received Claim ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Received Claim Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| PerformedStartDate |
|
||||
|
Time Zone: Unspecified |
AttendingProviderDurableKey
: integerAttending provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part A Procedure Files Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part B DME File Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
CMS CJR Inpatient Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
CMS CJR Outpatient Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
CMS CJR Part B Claim Procedure Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
CMS CJR Surgical Procedure Load
| AttendingProviderId |
|
||||
|
If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL |
|||||
| AttendingProviderIdType |
If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable |
Data Aggregation ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Data Aggregation Service Line Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Externally Adjudicated Service Line Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Payer System Service Line Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Claim ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Received Claim Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
AttendingProviderSourceDataDurableKey
: integerAttending provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
"EpicProviderNpi" |
||
| AttendingProviderSourceName |
"NPPES" |
CMS ACO Part A Procedure Files Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
"EpicProviderNpi" |
||
| AttendingProviderSourceName |
"NPPES" |
CMS ACO Part B DME File Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
"NotApplicable" |
| AttendingProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
"NotApplicable" |
| AttendingProviderSourceName |
NULL |
CMS CJR DME Claim Procedure Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
NotApplicable |
| AttendingProviderSourceName |
NULL |
CMS CJR Home Health Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| AttendingProviderSourceName |
"NPPES" |
CMS CJR Inpatient Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| AttendingProviderSourceName |
"NPPES" |
CMS CJR Outpatient Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| AttendingProviderSourceName |
"NPPES" |
CMS CJR Part B Claim Procedure Load
| AttendingProviderId |
NULL |
| AttendingProviderIdType |
NotApplicable |
| AttendingProviderSourceName |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| AttendingProviderId |
|
||
| AttendingProviderIdType |
EpicProviderNpi |
||
| AttendingProviderSourceName |
"NPPES" |
CMS CJR Surgical Procedure Load
| AttendingProviderId |
|
||||
|
If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL |
|||||
| AttendingProviderIdType |
If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable |
||||
| AttendingProviderSourceName |
"NPPES" |
Data Aggregation ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Data Aggregation Service Line Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated Service Line Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System Service Line Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Claim ICD Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Claim Procedure Load
| AttendingProviderId |
|
||||
|
If ATT_PROV_NPI is not NULL then ATT_PROV_NPI Otherwise ATTEND_PROV_ID |
|||||
| AttendingProviderIdType |
|
||||
|
If ATT_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||
| AttendingProviderSourceName |
|
||||
|
If ATT_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
OperatingProviderKey
: integerOperating provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part A Procedure Files Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
CMS ACO Part B DME File Load
| OperatingProviderId |
NULL |
||
| OperatingProviderIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part B Physicians File Load
| OperatingProviderId |
NULL |
||
| OperatingProviderIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Procedure Load
| OperatingProviderId |
NULL |
||
| OperatingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Home Health Claim Procedure Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| PerformedStartDate |
|
||
CMS CJR Inpatient Claim Procedure Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| PerformedStartDate |
|
||
CMS CJR Outpatient Claim Procedure Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| PerformedStartDate |
|
||
CMS CJR Part B Claim Procedure Load
| OperatingProviderId |
NULL |
||
| OperatingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| OperatingProviderId |
|
||
|
NULL |
|||
| OperatingProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
CMS CJR Surgical Procedure Load
| OperatingProviderId |
|
||||
|
If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL |
|||||
| OperatingProviderIdType |
If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable |
||||
| PerformedStartDate |
|
||||
Data Aggregation ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Data Aggregation Service Line Load
| OperatingProviderId |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||
| OperatingProviderIdType |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
Externally Adjudicated ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Externally Adjudicated Service Line Load
| OperatingProviderId |
|
||||||
|
If LN_OPR_NPI is not NULL then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||
| OperatingProviderIdType |
|
||||||
|
If LN_OPR_NPI is not NULL or OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
Payer System ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Payer System Service Line Load
| OperatingProviderId |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||
| OperatingProviderIdType |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
Received Claim ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Received Claim Procedure Load
| OperatingProviderId |
|
||||||||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||||||||
| OperatingProviderIdType |
|
||||||||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||||||||
| PerformedStartDate |
|
||||||||||||
|
Time Zone: Unspecified |
OperatingProviderDurableKey
: integerOperating provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part A Procedure Files Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part B DME File Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
CMS CJR Inpatient Claim Procedure Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
CMS CJR Outpatient Claim Procedure Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
CMS CJR Part B Claim Procedure Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OperatingProviderId |
|
||
|
NULL |
|||
| OperatingProviderIdType |
"EpicProviderNpi" |
CMS CJR Surgical Procedure Load
| OperatingProviderId |
|
||||
|
If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL |
|||||
| OperatingProviderIdType |
If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable |
Data Aggregation ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Data Aggregation Service Line Load
| OperatingProviderId |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||
| OperatingProviderIdType |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Externally Adjudicated Service Line Load
| OperatingProviderId |
|
||||||
|
If LN_OPR_NPI is not NULL then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||
| OperatingProviderIdType |
|
||||||
|
If LN_OPR_NPI is not NULL or OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Payer System Service Line Load
| OperatingProviderId |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||
| OperatingProviderIdType |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Claim ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Received Claim Procedure Load
| OperatingProviderId |
|
||||||||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||||||||
| OperatingProviderIdType |
|
||||||||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
OperatingProviderSourceDataDurableKey
: integerOperating provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
||
| OperatingProviderSourceName |
"NPPES" |
CMS ACO Part A Procedure Files Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
"EpicProviderNpi" |
||
| OperatingProviderSourceName |
"NPPES" |
CMS ACO Part B DME File Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
"NotApplicable" |
| OperatingProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
"NotApplicable" |
| OperatingProviderSourceName |
NULL |
CMS CJR DME Claim Procedure Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
NotApplicable |
| OperatingProviderSourceName |
NULL |
CMS CJR Home Health Claim Procedure Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| OperatingProviderSourceName |
"NPPES" |
CMS CJR Inpatient Claim Procedure Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| OperatingProviderSourceName |
"NPPES" |
CMS CJR Outpatient Claim Procedure Load
| OperatingProviderId |
|
||
| OperatingProviderIdType |
EpicProviderNpi |
||
| OperatingProviderSourceName |
"NPPES" |
CMS CJR Part B Claim Procedure Load
| OperatingProviderId |
NULL |
| OperatingProviderIdType |
NotApplicable |
| OperatingProviderSourceName |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| OperatingProviderId |
|
||
|
NULL |
|||
| OperatingProviderIdType |
"EpicProviderNpi" |
||
| OperatingProviderSourceName |
"NPPES" |
CMS CJR Surgical Procedure Load
| OperatingProviderId |
|
||||
|
If claim is inpatient or skilled nursing then AT_NPI Otherwise NULL |
|||||
| OperatingProviderIdType |
If claim is inpatient or skilled nursing then EpicProviderNpi Otherwise NotApplicable |
||||
| OperatingProviderSourceName |
"NPPES" |
Data Aggregation ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| OperatingProviderSourceName |
|
||||
|
If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Data Aggregation Service Line Load
| OperatingProviderId |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||
| OperatingProviderIdType |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| OperatingProviderSourceName |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| OperatingProviderSourceName |
|
||||
|
If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated Service Line Load
| OperatingProviderId |
|
||||||
|
If LN_OPR_NPI is not NULL then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||
| OperatingProviderIdType |
|
||||||
|
If LN_OPR_NPI is not NULL or OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| OperatingProviderSourceName |
|
||||||
|
If OPER_PROV_NPI is not NULL or LN_OPR_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| OperatingProviderSourceName |
|
||||
|
If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System Service Line Load
| OperatingProviderId |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||
| OperatingProviderIdType |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| OperatingProviderSourceName |
|
||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Claim ICD Procedure Load
| OperatingProviderId |
|
||||
|
If OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||
| OperatingProviderIdType |
|
||||
|
If OPER_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| OperatingProviderSourceName |
|
||||
|
If OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Claim Procedure Load
| OperatingProviderId |
|
||||||||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OPR_NPI Otherwise if OPER_PROV_NPI is not NULL then OPER_PROV_NPI Otherwise OPERATING_PROV_ID |
|||||||||||||
| OperatingProviderIdType |
|
||||||||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OPER_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||||||||
| OperatingProviderSourceName |
|
||||||||||||
|
If LN_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OPER_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
OtherProviderKey
: integerOther provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderId |
|
||
| OtherProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part A Procedure Files Load
| OtherProviderId |
|
||
| OtherProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
CMS ACO Part B DME File Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part B Physicians File Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Procedure Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Home Health Claim Procedure Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Inpatient Claim Procedure Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Outpatient Claim Procedure Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Part B Claim Procedure Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Surgical Procedure Load
| OtherProviderId |
NULL |
||
| OtherProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
Data Aggregation ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Data Aggregation Service Line Load
| OtherProviderId |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||
| OtherProviderIdType |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
Externally Adjudicated ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Externally Adjudicated Service Line Load
| OtherProviderId |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||
| OtherProviderIdType |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL or OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
Payer System ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Payer System Service Line Load
| OtherProviderId |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||
| OtherProviderIdType |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
Received Claim ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| PerformedStartDate |
|
||||
Received Claim Procedure Load
| OtherProviderId |
|
||||||||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||||||||
| OtherProviderIdType |
|
||||||||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||||||||
| PerformedStartDate |
|
||||||||||||
|
Time Zone: Unspecified |
OtherProviderDurableKey
: integerOther provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderId |
|
||
| OtherProviderIdType |
"EpicProviderNpi" |
CMS ACO Part A Procedure Files Load
| OtherProviderId |
|
||
| OtherProviderIdType |
"EpicProviderNpi" |
CMS ACO Part B DME File Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
CMS CJR Surgical Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Data Aggregation Service Line Load
| OtherProviderId |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||
| OtherProviderIdType |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Externally Adjudicated ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Externally Adjudicated Service Line Load
| OtherProviderId |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||
| OtherProviderIdType |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL or OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Payer System ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Payer System Service Line Load
| OtherProviderId |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||
| OtherProviderIdType |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
Received Claim ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
Received Claim Procedure Load
| OtherProviderId |
|
||||||||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||||||||
| OtherProviderIdType |
|
||||||||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
OtherProviderSourceDataDurableKey
: integerOther provider associated with the procedure. For Epic data, this is copied from the header level of the claim.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderId |
|
||
| OtherProviderIdType |
"EpicProviderNpi" |
||
| OtherProviderSourceName |
"NPPES" |
CMS ACO Part A Procedure Files Load
| OtherProviderId |
|
||
| OtherProviderIdType |
"EpicProviderNpi" |
||
| OtherProviderSourceName |
"NPPES" |
CMS ACO Part B DME File Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
"NotApplicable" |
| OtherProviderSourceName |
NULL |
CMS ACO Part B Physicians File Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
"NotApplicable" |
| OtherProviderSourceName |
NULL |
CMS CJR DME Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Home Health Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Inpatient Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Outpatient Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Part B Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
CMS CJR Surgical Procedure Load
| OtherProviderId |
NULL |
| OtherProviderIdType |
NotApplicable |
| OtherProviderSourceName |
NULL |
Data Aggregation ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| OtherProviderSourceName |
|
||||
|
If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Data Aggregation Service Line Load
| OtherProviderId |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||
| OtherProviderIdType |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| OtherProviderSourceName |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| OtherProviderSourceName |
|
||||
|
If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Externally Adjudicated Service Line Load
| OtherProviderId |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||
| OtherProviderIdType |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL or OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| OtherProviderSourceName |
|
||||||
|
If OTH_PROV_NPI is not NULL or LN_OTH_OPR_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| OtherProviderSourceName |
|
||||
|
If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Payer System Service Line Load
| OtherProviderId |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||
| OtherProviderIdType |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||
| OtherProviderSourceName |
|
||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Claim ICD Procedure Load
| OtherProviderId |
|
||||
|
If OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||
| OtherProviderIdType |
|
||||
|
If OTH_PROV_NPI is not NULL then EpicProviderNpi Otherwise EpicProviderId |
|||||
| OtherProviderSourceName |
|
||||
|
If OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
Received Claim Procedure Load
| OtherProviderId |
|
||||||||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then LN_OTH_OPR_NPI Otherwise if OTH_PROV_NPI is not NULL then OTH_PROV_NPI Otherwise OTHER_PROV_ID |
|||||||||||||
| OtherProviderIdType |
|
||||||||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "EpicProviderNpi" Otherwise if OTH_PROV_NPI is not NULL then "EpicProviderNpi" Otherwise "EpicProviderId" |
|||||||||||||
| OtherProviderSourceName |
|
||||||||||||
|
If LN_OTH_OPR_NPI is not NULL and the number of services has not been modified in the system then "NPPES" Otherwise if OTH_PROV_NPI is not NULL then "NPPES" Otherwise NULL (use source of the package) |
OrderingProviderKey
: integerProvider who ordered the procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part A Procedure Files Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
CMS ACO Part B DME File Load
| OrderingProviderId |
|
||
| OrderingProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part B Physicians File Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Home Health Claim Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Inpatient Claim Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Outpatient Claim Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Part B Claim Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
CMS CJR Surgical Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
Data Aggregation ICD Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
Data Aggregation Service Line Load
| OrderingProviderId |
|
||
|
If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI |
|||
| OrderingProviderIdType |
|
||
|
"EpicProviderNpi" |
|||
| PerformedStartDate |
|
||
|
Time Zone: Unspecified |
Externally Adjudicated ICD Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
Externally Adjudicated Service Line Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
"Unspecified" |
||
| PerformedStartDate |
|
||
|
Time Zone: Unspecified |
Payer System ICD Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
Payer System Service Line Load
| OrderingProviderId |
|
||
|
If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI |
|||
| OrderingProviderIdType |
"EpicProviderNpi" |
||
| PerformedStartDate |
|
||
|
Time Zone: Unspecified |
Received Claim ICD Procedure Load
| OrderingProviderId |
NULL |
||
| OrderingProviderIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
Received Claim Procedure Load
| OrderingProviderId |
|
||||||||
|
If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI |
|||||||||
| OrderingProviderIdType |
"EpicProviderNpi" |
||||||||
| PerformedStartDate |
|
||||||||
|
Time Zone: Unspecified |
OrderingProviderDurableKey
: integerProvider who ordered the procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| OrderingProviderId |
|
||
| OrderingProviderIdType |
"EpicProviderNpi" |
CMS ACO Part B Physicians File Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
CMS CJR Surgical Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
Data Aggregation Service Line Load
| OrderingProviderId |
|
||
|
If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI |
|||
| OrderingProviderIdType |
|
||
|
"EpicProviderNpi" |
Externally Adjudicated ICD Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
"Unspecified" |
Payer System ICD Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
Payer System Service Line Load
| OrderingProviderId |
|
||
|
If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI |
|||
| OrderingProviderIdType |
"EpicProviderNpi" |
Received Claim ICD Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
Received Claim Procedure Load
| OrderingProviderId |
|
||||||||
|
If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI |
|||||||||
| OrderingProviderIdType |
"EpicProviderNpi" |
OrderingProviderSourceDataDurableKey
: integerProvider who ordered the procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
"NotApplicable" |
| OrderingProviderSourceName |
NULL |
CMS ACO Part A Procedure Files Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
"NotApplicable" |
| OrderingProviderSourceName |
NULL |
CMS ACO Part B DME File Load
| OrderingProviderId |
|
||
| OrderingProviderIdType |
"EpicProviderNpi" |
||
| OrderingProviderSourceName |
"NPPES" |
CMS ACO Part B Physicians File Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
"NotApplicable" |
| OrderingProviderSourceName |
NULL |
CMS CJR DME Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
CMS CJR Home Health Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
CMS CJR Inpatient Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
CMS CJR Outpatient Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
CMS CJR Part B Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
CMS CJR Surgical Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
Data Aggregation ICD Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
Data Aggregation Service Line Load
| OrderingProviderId |
|
||
|
If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI |
|||
| OrderingProviderIdType |
|
||
|
"EpicProviderNpi" |
|||
| OrderingProviderSourceName |
|
||
|
If LN_ORD_NPI is not NULL and the number of services has not been modified in the system then "NPPES" |
Externally Adjudicated ICD Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
Externally Adjudicated Service Line Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
"Unspecified" |
| OrderingProviderSourceName |
Payer System ICD Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
Payer System Service Line Load
| OrderingProviderId |
|
||
|
If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI |
|||
| OrderingProviderIdType |
"EpicProviderNpi" |
||
| OrderingProviderSourceName |
|
||
|
If LN_ORD_NPI is not NULL and the number of services has not been modified in the system then "NPPES" |
Received Claim ICD Procedure Load
| OrderingProviderId |
NULL |
| OrderingProviderIdType |
NotApplicable |
| OrderingProviderSourceName |
NULL |
Received Claim Procedure Load
| OrderingProviderId |
|
||||||||
|
If the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI |
|||||||||
| OrderingProviderIdType |
"EpicProviderNpi" |
||||||||
| OrderingProviderSourceName |
|
||||||||
|
If LN_ORD_NPI is not NULL and the number of services has not been modified in the system then "NPPES" |
DrgKey
: integerDiagnosis Related Group (DRG) associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| DrgId |
This column isn't configured for use in reports. See an administrator for more information. |
| DrgIdType |
This column isn't configured for use in reports. See an administrator for more information. |
CMS ACO Part A Procedure Files Load
| DrgId |
This column isn't configured for use in reports. See an administrator for more information. |
| DrgIdType |
This column isn't configured for use in reports. See an administrator for more information. |
CMS ACO Part B DME File Load
| DrgId |
NULL |
| DrgIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| DrgId |
NULL |
| DrgIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| DrgId |
NULL |
| DrgIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| DrgId |
NULL |
| DrgIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| DrgId |
This column isn't configured for use in reports. See an administrator for more information. |
| DrgIdType |
This column isn't configured for use in reports. See an administrator for more information. |
CMS CJR Outpatient Claim Procedure Load
| DrgId |
NULL |
| DrgIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| DrgId |
NULL |
| DrgIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| DrgId |
This column isn't configured for use in reports. See an administrator for more information. |
| DrgIdType |
This column isn't configured for use in reports. See an administrator for more information. |
CMS CJR Surgical Procedure Load
| DrgId |
NULL |
| DrgIdType |
If the claim is inpatient or skilled nursing then Unspecified Otherwise If the claim is Part B or hospice then NotApplicable |
Data Aggregation ICD Procedure Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Data Aggregation Service Line Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Externally Adjudicated ICD Procedure Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Externally Adjudicated Service Line Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Payer System ICD Procedure Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Payer System Service Line Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Received Claim ICD Procedure Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
Received Claim Procedure Load
| DrgId |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then DRG_ID_TYPE_ID + "|" + DRG_ID Otherwise DRG_ID |
|||||
| DrgIdType |
|
||||
|
If DRG_ID_TYPE_ID is not NULL then "EpicIdentityId|DrgId" Otherwise "EpicDrgId" |
RevenueCodeKey
: integerRevenue code associated with the procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| RevenueCodeId |
|
||
| RevenueCodeIdType |
"EpicRevenueCode" |
CMS ACO Part A Procedure Files Load
| RevenueCodeId |
NULL |
| RevenueCodeIdType |
NotApplicable |
CMS ACO Part B DME File Load
| RevenueCodeId |
NULL |
| RevenueCodeIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| RevenueCodeId |
NULL |
| RevenueCodeIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| RevenueCodeId |
NULL |
| RevenueCodeIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| RevenueCodeId |
|
||
| RevenueCodeIdType |
EpicRevenueCode |
CMS CJR Inpatient Claim Procedure Load
| RevenueCodeId |
|
||
| RevenueCodeIdType |
EpicRevenueCode |
CMS CJR Outpatient Claim Procedure Load
| RevenueCodeId |
|
||
| RevenueCodeIdType |
EpicRevenueCode |
CMS CJR Part B Claim Procedure Load
| RevenueCodeId |
NULL |
| RevenueCodeIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| RevenueCodeId |
|
||
| RevenueCodeIdType |
EpicRevenueCode |
CMS CJR Surgical Procedure Load
| RevenueCodeId |
NULL |
| RevenueCodeIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| RevenueCodeId |
NULL |
| RevenueCodeIdType |
NotApplicable |
Data Aggregation Service Line Load
| RevenueCodeId |
|
||||
|
If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI LN_REV_CD |
|||||
| RevenueCodeIdType |
|
||||
|
"EpicRevenueCode" |
Externally Adjudicated ICD Procedure Load
| RevenueCodeId |
NULL |
| RevenueCodeIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| RevenueCodeId |
|
||||
|
If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise LN_REV_CD |
|||||
| RevenueCodeIdType |
"EpicRevenueCode" |
Payer System ICD Procedure Load
| RevenueCodeId |
NULL |
| RevenueCodeIdType |
NotApplicable |
Payer System Service Line Load
| RevenueCodeId |
|
||||
|
If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI LN_REV_CD |
|||||
| RevenueCodeIdType |
"EpicRevenueCode" |
Received Claim ICD Procedure Load
| RevenueCodeId |
NULL |
| RevenueCodeIdType |
NotApplicable |
Received Claim Procedure Load
| RevenueCodeId |
|
||||||||||
|
If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then SVC_LN_INFO.LN_ORD_NPI LN_REV_CD |
|||||||||||
| RevenueCodeIdType |
"EpicRevenueCode" |
PrimaryDiagnosisKey
: integerPrimary claim diagnosis
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable" |
CMS ACO Part A Procedure Files Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable" |
CMS ACO Part B DME File Load
| PrimaryDiagnosisId |
NULL |
| PrimaryDiagnosisIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable" |
CMS CJR DME Claim Procedure Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Home Health Claim Procedure Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Inpatient Claim Procedure Load
| PrimaryDiagnosisId |
|
||||||
| PrimaryDiagnosisIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified |
CMS CJR Outpatient Claim Procedure Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Part B Claim Procedure Load
| PrimaryDiagnosisId |
|
||||
| PrimaryDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Skilled Nursing Claim Procedure Load
| PrimaryDiagnosisId |
|
||||||
| PrimaryDiagnosisIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified |
CMS CJR Surgical Procedure Load
| PrimaryDiagnosisId |
|
||||||||||||||||||||
| PrimaryDiagnosisIdType |
|
||||||||||||||||||||
|
If claim is inpatient or skilled nursing: If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified Otherwise if claim is Part B or hospice: If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
Externally Adjudicated ICD Procedure Load
| PrimaryDiagnosisId |
NULL |
| PrimaryDiagnosisIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| PrimaryDiagnosisId | |
| PrimaryDiagnosisIdType |
"Unspecified" |
Received Claim ICD Procedure Load
| PrimaryDiagnosisId |
|
||||
|
DX_ID where LINE = 1 |
|||||
| PrimaryDiagnosisIdType |
EpicDiagnosisId |
Received Claim Procedure Load
| PrimaryDiagnosisId |
|
||||
|
DX_ID where LINE = 1 |
|||||
| PrimaryDiagnosisIdType |
"EpicDiagnosisId" |
AdmittingDiagnosisKey
: integerClaim diagnosis for which the beneficiary was admitted
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmittingDiagnosisId |
|
||||
| AdmittingDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable" |
CMS ACO Part A Procedure Files Load
| AdmittingDiagnosisId |
|
||||
| AdmittingDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "NotApplicable" |
CMS ACO Part B DME File Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| AdmittingDiagnosisId |
|
||||||
| AdmittingDiagnosisIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified |
CMS CJR Outpatient Claim Procedure Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| AdmittingDiagnosisId |
NULL |
| AdmittingDiagnosisIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AdmittingDiagnosisId |
|
||||||
| AdmittingDiagnosisIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified |
CMS CJR Surgical Procedure Load
| AdmittingDiagnosisId |
|
||||||||||||
|
If claim is inpatient or skilled nursing then ADMTG_DGNS_CD Otherwise NULL |
|||||||||||||
| AdmittingDiagnosisIdType |
|
||||||||||||
|
If claim is inpatient or skilled nursing: If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-CM Otherwise Unspecified Otherwise if claim is Part B or hospice then NotApplicable |
Data Aggregation ICD Procedure Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
EpicDiagnosisId |
Data Aggregation Service Line Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
|
||
|
"EpicDiagnosisId" |
Externally Adjudicated ICD Procedure Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
EpicDiagnosisId |
Externally Adjudicated Service Line Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
"EpicDiagnosisId" |
Payer System ICD Procedure Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
EpicDiagnosisId |
Payer System Service Line Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
"EpicDiagnosisId" |
Received Claim ICD Procedure Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
EpicDiagnosisId |
Received Claim Procedure Load
| AdmittingDiagnosisId |
|
||
| AdmittingDiagnosisIdType |
"EpicDiagnosisId" |
DiagnosisComboKey
: integerAll diagnoses associated with the procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| DiagnosisComboId |
|
||||
|
CUR_CLM_UNIQ_ID + "|" + CLM_LINE_NUM |
|||||
| DiagnosisComboIdType |
"MsspClaimUniqueId|Line" |
CMS CJR DME Claim Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
CMS CJR Surgical Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
Data Aggregation Service Line Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
"EpicArTransactionId:ReceivedClaimProcedure" |
Externally Adjudicated ICD Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
"EpicArTransactionId:ReceivedClaimProcedure" |
Payer System ICD Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
Payer System Service Line Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
"EpicArTransactionId:ReceivedClaimProcedure" |
Received Claim ICD Procedure Load
| DiagnosisComboId |
NULL |
| DiagnosisComboIdType |
NotApplicable |
Received Claim Procedure Load
| DiagnosisComboId |
|
||
| DiagnosisComboIdType |
"EpicArTransactionId:ReceivedClaimProcedure" |
DiagnosisComboIdTypeId
: integerThe IdTypeId corresponding to the DiagnosisBridge lookup
Properties
- Data type
- integer
- SQL Server data type
- smallint
- Allows null
- Yes
DiagnosisNumericId
: numberThe NumericId corresponding to the DiagnosisBridge lookup. If this column is populated, then DiagnosisComboId will not be populated. Cannot and should not be populated by packages.
Properties
- Data type
- number
- SQL Server data type
- numeric(38,0)
- Allows null
- Yes
DiagnosisComboId
: stringThe Id corresponding to the DiagnosisBridge lookup
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- Yes
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| DiagnosisComboId |
NULL |
CMS ACO Part A Procedure Files Load
| DiagnosisComboId |
NULL |
CMS ACO Part B DME File Load
| DiagnosisComboId |
NULL |
CMS ACO Part B Physicians File Load
| DiagnosisComboId |
|
||||
|
CUR_CLM_UNIQ_ID + "|" + CLM_LINE_NUM |
CMS CJR DME Claim Procedure Load
| DiagnosisComboId |
NULL |
CMS CJR Home Health Claim Procedure Load
| DiagnosisComboId |
NULL |
CMS CJR Inpatient Claim Procedure Load
| DiagnosisComboId |
NULL |
CMS CJR Outpatient Claim Procedure Load
| DiagnosisComboId |
NULL |
CMS CJR Part B Claim Procedure Load
| DiagnosisComboId |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| DiagnosisComboId |
NULL |
CMS CJR Surgical Procedure Load
| DiagnosisComboId |
NULL |
Data Aggregation ICD Procedure Load
| DiagnosisComboId |
NULL |
Data Aggregation Service Line Load
| DiagnosisComboId |
|
||
Externally Adjudicated ICD Procedure Load
| DiagnosisComboId |
NULL |
Externally Adjudicated Service Line Load
| DiagnosisComboId |
|
||
Payer System ICD Procedure Load
| DiagnosisComboId |
NULL |
Payer System Service Line Load
| DiagnosisComboId |
|
||
Received Claim ICD Procedure Load
| DiagnosisComboId |
NULL |
Received Claim Procedure Load
| DiagnosisComboId |
|
||
FirstDiagnosisKey
: integerFirst diagnosis associated with the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| FirstDiagnosisId |
|
||
| FirstDiagnosisIdType |
If MsspPartADiagnosisCode.FirstDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FirstDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unspecified" |
CMS ACO Part A Procedure Files Load
| FirstDiagnosisId |
|
||
| FirstDiagnosisIdType |
If MsspPartADiagnosisCode.FirstDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FirstDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unspecified" |
CMS ACO Part B DME File Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| FirstDiagnosisId |
|
||||
| FirstDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS CJR DME Claim Procedure Load
| FirstDiagnosisId |
|
||||
| FirstDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Home Health Claim Procedure Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| FirstDiagnosisId |
|
||||||
| FirstDiagnosisIdType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Part B Claim Procedure Load
| FirstDiagnosisId |
|
||||
| FirstDiagnosisIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Skilled Nursing Claim Procedure Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
NotApplicable |
CMS CJR Surgical Procedure Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
NotApplicable |
Data Aggregation Service Line Load
| FirstDiagnosisId |
|
||||
| FirstDiagnosisIdType |
|
||||
|
"EpicDiagnosisId" |
Externally Adjudicated ICD Procedure Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| FirstDiagnosisId |
|
||||
|
DX_ID where AP_PROC_ASSOC_DX.LINE = 1 |
|||||
| FirstDiagnosisIdType |
EpicDiagnosisId |
Payer System ICD Procedure Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
NotApplicable |
Payer System Service Line Load
| FirstDiagnosisId |
|
||||
| FirstDiagnosisIdType |
|
||||
|
"EpicDiagnosisId" |
Received Claim ICD Procedure Load
| FirstDiagnosisId |
NULL |
| FirstDiagnosisIdType |
NotApplicable |
Received Claim Procedure Load
| FirstDiagnosisId |
|
||||
|
DX_ID where AP_PROC_ASSOC_DX.LINE = 1 |
|||||
| FirstDiagnosisIdType |
EpicDiagnosisId |
BillingProcedureKey
: integerBilling procedure associated with the claim line
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
|
||
|
"EpicHippsCode" if CLM_LINE_PROD_REV_CTR_CD is 0022, 0023, or 0024; otherwise "EpicHcpcsCode" |
|||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part A Procedure Files Load
| BillingProcedureId |
NULL |
||
| BillingProcedureIdType |
"NotApplicable" |
||
| PerformedStartDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
CMS ACO Part B DME File Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
"EpicHcpcsCode" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part B Physicians File Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
"EpicHcpcsCode" |
||
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
||
| PerformedStartDate |
|
||
CMS CJR Home Health Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
||
| PerformedStartDate |
|
||
CMS CJR Inpatient Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
||
| PerformedStartDate |
|
||
CMS CJR Outpatient Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
||
| PerformedStartDate |
|
||
CMS CJR Part B Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
||
| PerformedStartDate |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
||
| PerformedStartDate |
|
||
CMS CJR Surgical Procedure Load
| BillingProcedureId |
|
||||||||||||||||||||
| BillingProcedureIdType |
|
||||||||||||||||||||
|
If claim is inpatient or skilled nursing: If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-PCS Otherwise Unspecified Otherwise if the claim is Part B or hospice: If no CODE_VALUE for this claim where CLM_PROD_TYPE_CD = S-Procedure exists then HcpcsCode Otherwise If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-PCS Otherwise Unspecified |
|||||||||||||||||||||
| PerformedStartDate |
|
||||||||||||||||||||
Data Aggregation ICD Procedure Load
| BillingProcedureId |
NULL |
||
| BillingProcedureIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
Data Aggregation Service Line Load
| BillingProcedureId |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||
| BillingProcedureIdType |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
|||||||
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
Externally Adjudicated ICD Procedure Load
| BillingProcedureId |
NULL |
||
| BillingProcedureIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
Externally Adjudicated Service Line Load
| BillingProcedureId |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then LN_PROC_CD |
|||||||||||||
| BillingProcedureIdType |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then "EpicHcpcsCode" |
|||||||||||||
| PerformedStartDate |
|
||||||||||||
|
Time Zone: Unspecified |
Payer System ICD Procedure Load
| BillingProcedureId |
NULL |
||
| BillingProcedureIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
Payer System Service Line Load
| BillingProcedureId |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||
| BillingProcedureIdType |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
|||||||
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
Received Claim ICD Procedure Load
| BillingProcedureId |
NULL |
||
| BillingProcedureIdType |
NotApplicable |
||
| PerformedStartDate |
|
||
Received Claim Procedure Load
| BillingProcedureId |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||||||||
| BillingProcedureIdType |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
|||||||||||||
| PerformedStartDate |
|
||||||||||||
|
Time Zone: Unspecified |
BillingProcedureDurableKey
: integerBilling procedure associated with the claim line
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
|
||
|
"EpicHippsCode" if CLM_LINE_PROD_REV_CTR_CD is 0022, 0023, or 0024; otherwise "EpicHcpcsCode" |
CMS ACO Part A Procedure Files Load
| BillingProcedureId |
NULL |
| BillingProcedureIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
"EpicHcpcsCode" |
CMS ACO Part B Physicians File Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
"EpicHcpcsCode" |
CMS CJR DME Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
CMS CJR Home Health Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
CMS CJR Inpatient Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
CMS CJR Outpatient Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
CMS CJR Part B Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
CMS CJR Skilled Nursing Claim Procedure Load
| BillingProcedureId |
|
||
| BillingProcedureIdType |
EpicHcpcsCode |
CMS CJR Surgical Procedure Load
| BillingProcedureId |
|
||||||||||||||||||||
| BillingProcedureIdType |
|
||||||||||||||||||||
|
If claim is inpatient or skilled nursing: If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-PCS Otherwise Unspecified Otherwise if the claim is Part B or hospice: If no CODE_VALUE for this claim where CLM_PROD_TYPE_CD = S-Procedure exists then HcpcsCode Otherwise If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-PCS Otherwise Unspecified |
Data Aggregation ICD Procedure Load
| BillingProcedureId |
NULL |
| BillingProcedureIdType |
NotApplicable |
Data Aggregation Service Line Load
| BillingProcedureId |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||
| BillingProcedureIdType |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
Externally Adjudicated ICD Procedure Load
| BillingProcedureId |
NULL |
| BillingProcedureIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| BillingProcedureId |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then LN_PROC_CD |
|||||||||||||
| BillingProcedureIdType |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then "EpicHcpcsCode" |
Payer System ICD Procedure Load
| BillingProcedureId |
NULL |
| BillingProcedureIdType |
NotApplicable |
Payer System Service Line Load
| BillingProcedureId |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||
| BillingProcedureIdType |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
Received Claim ICD Procedure Load
| BillingProcedureId |
NULL |
| BillingProcedureIdType |
NotApplicable |
Received Claim Procedure Load
| BillingProcedureId |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||||||||
| BillingProcedureIdType |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
ProcedureKey
: integerProcedure associated with the claim line
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
|||
| ProcedureId |
|
||
| ProcedureIdType |
|
||
|
"EpicHippsCode" if CLM_LINE_PROD_REV_CTR_CD is 0022, 0023, or 0024; otherwise "EpicHcpcsCode" |
CMS ACO Part A Procedure Files Load
| PerformedStartDate |
|
||||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
|||||
| ProcedureId |
|
||||
| ProcedureIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-PCS" Otherwise "NotApplicable" |
CMS ACO Part B DME File Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
|||
| ProcedureId |
|
||
| ProcedureIdType |
"EpicHcpcsCode" |
CMS ACO Part B Physicians File Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
|||
| ProcedureId |
|
||
| ProcedureIdType |
"EpicHcpcsCode" |
CMS CJR DME Claim Procedure Load
| PerformedStartDate |
|
||
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Home Health Claim Procedure Load
| PerformedStartDate |
|
||
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Inpatient Claim Procedure Load
| PerformedStartDate |
|
||
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Outpatient Claim Procedure Load
| PerformedStartDate |
|
||
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Part B Claim Procedure Load
| PerformedStartDate |
|
||
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Skilled Nursing Claim Procedure Load
| PerformedStartDate |
|
||
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Surgical Procedure Load
| PerformedStartDate |
|
||||||||||||||||||||
| ProcedureId |
|
||||||||||||||||||||
| ProcedureIdType |
|
||||||||||||||||||||
|
If claim is inpatient or skilled nursing: If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-PCS Otherwise Unspecified Otherwise if the claim is Part B or hospice: If no CODE_VALUE for this claim where CLM_PROD_TYPE_CD = S-Procedure exists then HcpcsCode Otherwise If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-PCS Otherwise Unspecified |
Data Aggregation ICD Procedure Load
| PerformedStartDate |
|
||
| ProcedureId |
|
||
| ProcedureIdType |
EpicIcdCode |
Data Aggregation Service Line Load
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
|||||||
| ProcedureId |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||
| ProcedureIdType |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
Externally Adjudicated ICD Procedure Load
| PerformedStartDate |
|
||
| ProcedureId |
|
||
| ProcedureIdType |
EpicIcdCode |
Externally Adjudicated Service Line Load
| PerformedStartDate |
|
||||||||||||
|
Time Zone: Unspecified |
|||||||||||||
| ProcedureId |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then LN_PROC_CD |
|||||||||||||
| ProcedureIdType |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then "EpicHcpcsCode" |
Payer System ICD Procedure Load
| PerformedStartDate |
|
||
| ProcedureId |
|
||
| ProcedureIdType |
EpicIcdCode |
Payer System Service Line Load
| PerformedStartDate |
|
||||||
|
Time Zone: Unspecified |
|||||||
| ProcedureId |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||
| ProcedureIdType |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
Received Claim ICD Procedure Load
| PerformedStartDate |
|
||
| ProcedureId |
|
||
| ProcedureIdType |
EpicIcdCode |
Received Claim Procedure Load
| PerformedStartDate |
|
||||||||||||
|
Time Zone: Unspecified |
|||||||||||||
| ProcedureId |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||||||||
| ProcedureIdType |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
ProcedureDurableKey
: integerProcedure associated with the claim line
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ProcedureId |
|
||
| ProcedureIdType |
|
||
|
"EpicHippsCode" if CLM_LINE_PROD_REV_CTR_CD is 0022, 0023, or 0024; otherwise "EpicHcpcsCode" |
CMS ACO Part A Procedure Files Load
| ProcedureId |
|
||||
| ProcedureIdType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-PCS" Otherwise "NotApplicable" |
CMS ACO Part B DME File Load
| ProcedureId |
|
||
| ProcedureIdType |
"EpicHcpcsCode" |
CMS ACO Part B Physicians File Load
| ProcedureId |
|
||
| ProcedureIdType |
"EpicHcpcsCode" |
CMS CJR DME Claim Procedure Load
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Home Health Claim Procedure Load
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Inpatient Claim Procedure Load
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Outpatient Claim Procedure Load
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Part B Claim Procedure Load
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Skilled Nursing Claim Procedure Load
| ProcedureId |
|
||
| ProcedureIdType |
EpicHcpcsCode |
CMS CJR Surgical Procedure Load
| ProcedureId |
|
||||||||||||||||||||
| ProcedureIdType |
|
||||||||||||||||||||
|
If claim is inpatient or skilled nursing: If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-PCS Otherwise Unspecified Otherwise if the claim is Part B or hospice: If no CODE_VALUE for this claim where CLM_PROD_TYPE_CD = S-Procedure exists then HcpcsCode Otherwise If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-PCS Otherwise Unspecified |
Data Aggregation ICD Procedure Load
| ProcedureId |
|
||
| ProcedureIdType |
EpicIcdCode |
Data Aggregation Service Line Load
| ProcedureId |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||
| ProcedureIdType |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
Externally Adjudicated ICD Procedure Load
| ProcedureId |
|
||
| ProcedureIdType |
EpicIcdCode |
Externally Adjudicated Service Line Load
| ProcedureId |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then LN_PROC_CD |
|||||||||||||
| ProcedureIdType |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then "EpicHcpcsCode" |
Payer System ICD Procedure Load
| ProcedureId |
|
||
| ProcedureIdType |
EpicIcdCode |
Payer System Service Line Load
| ProcedureId |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||
| ProcedureIdType |
|
||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
Received Claim ICD Procedure Load
| ProcedureId |
|
||
| ProcedureIdType |
EpicIcdCode |
Received Claim Procedure Load
| ProcedureId |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then PROC_ID Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
|||||||||||||
| ProcedureIdType |
|
||||||||||||
|
If AP_CLAIM_PROC.PROC_ID is not NULL then "EpicProcedureId" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then "EpicHcpcsCode" |
ModifierComboKey
: integerAll modifiers associated with the procedure
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
"NotApplicable" |
CMS ACO Part A Procedure Files Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
"NotApplicable" |
CMS ACO Part B DME File Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
"NotApplicable" |
CMS ACO Part B Physicians File Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
"NotApplicable" |
CMS CJR DME Claim Procedure Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
NotApplicable |
CMS CJR Inpatient Claim Procedure Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
NotApplicable |
CMS CJR Outpatient Claim Procedure Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
NotApplicable |
CMS CJR Part B Claim Procedure Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
NotApplicable |
Data Aggregation ICD Procedure Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
NotApplicable |
Data Aggregation Service Line Load
| ModifierComboId |
|
||||
| ModifierComboIdType |
"EpicArTransactionId" |
Externally Adjudicated ICD Procedure Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
NotApplicable |
Externally Adjudicated Service Line Load
| ModifierComboId |
|
||||
| ModifierComboIdType |
"EpicArTransactionId" |
Payer System ICD Procedure Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
NotApplicable |
Payer System Service Line Load
| ModifierComboId |
|
||||
| ModifierComboIdType |
"EpicArTransactionId" |
Received Claim ICD Procedure Load
| ModifierComboId |
NULL |
| ModifierComboIdType |
NotApplicable |
Received Claim Procedure Load
| ModifierComboId |
|
||||
| ModifierComboIdType |
"EpicArTransactionId" |
ModifierComboIdTypeId
: integerThe IdType ID corresponding to the ReceivedClaimProcedureModifierBridge lookup
Properties
- Data type
- integer
- SQL Server data type
- smallint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| ModifierComboIdTypeId |
CMS ACO Part A Procedure Files Load
| ModifierComboIdTypeId |
CMS ACO Part B DME File Load
| ModifierComboIdTypeId |
CMS ACO Part B Physicians File Load
| ModifierComboIdTypeId |
CMS CJR DME Claim Procedure Load
| ModifierComboIdTypeId |
CMS CJR Home Health Claim Procedure Load
| ModifierComboIdTypeId |
CMS CJR Inpatient Claim Procedure Load
| ModifierComboIdTypeId |
CMS CJR Outpatient Claim Procedure Load
| ModifierComboIdTypeId |
CMS CJR Part B Claim Procedure Load
| ModifierComboIdTypeId |
CMS CJR Surgical Procedure Load
| ModifierComboIdTypeId |
Data Aggregation ICD Procedure Load
| ModifierComboIdTypeId |
Data Aggregation Service Line Load
| ModifierComboIdTypeId |
Externally Adjudicated ICD Procedure Load
| ModifierComboIdTypeId |
Externally Adjudicated Service Line Load
| ModifierComboIdTypeId |
Payer System ICD Procedure Load
| ModifierComboIdTypeId |
Payer System Service Line Load
| ModifierComboIdTypeId |
Received Claim ICD Procedure Load
| ModifierComboIdTypeId |
Received Claim Procedure Load
| ModifierComboIdTypeId |
ModifierNumericId
: numberThe NumericId corresponding to the ReceivedClaimProcedureModifierBridge lookup. If this column is populated, then ModifierComboId will not be populated. Cannot and should not be populated by packages.
Properties
- Data type
- number
- SQL Server data type
- numeric(38,0)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| ModifierNumericId |
CMS ACO Part A Procedure Files Load
| ModifierNumericId |
CMS ACO Part B DME File Load
| ModifierNumericId |
CMS ACO Part B Physicians File Load
| ModifierNumericId |
CMS CJR DME Claim Procedure Load
| ModifierNumericId |
CMS CJR Home Health Claim Procedure Load
| ModifierNumericId |
CMS CJR Inpatient Claim Procedure Load
| ModifierNumericId |
CMS CJR Outpatient Claim Procedure Load
| ModifierNumericId |
CMS CJR Part B Claim Procedure Load
| ModifierNumericId |
CMS CJR Skilled Nursing Claim Procedure Load
| ModifierNumericId |
CMS CJR Surgical Procedure Load
| ModifierNumericId |
Data Aggregation ICD Procedure Load
| ModifierNumericId |
Data Aggregation Service Line Load
| ModifierNumericId |
Externally Adjudicated ICD Procedure Load
| ModifierNumericId |
Externally Adjudicated Service Line Load
| ModifierNumericId |
Payer System ICD Procedure Load
| ModifierNumericId |
Payer System Service Line Load
| ModifierNumericId |
Received Claim ICD Procedure Load
| ModifierNumericId |
Received Claim Procedure Load
| ModifierNumericId |
ModifierComboId
: stringThe Id corresponding to the ReceivedClaimProcedureModifierBridge lookup
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- Yes
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| ModifierComboId |
NULL |
CMS ACO Part A Procedure Files Load
| ModifierComboId |
NULL |
CMS ACO Part B DME File Load
| ModifierComboId |
NULL |
CMS ACO Part B Physicians File Load
| ModifierComboId |
NULL |
CMS CJR DME Claim Procedure Load
| ModifierComboId |
NULL |
CMS CJR Home Health Claim Procedure Load
| ModifierComboId |
NULL |
CMS CJR Inpatient Claim Procedure Load
| ModifierComboId |
NULL |
CMS CJR Outpatient Claim Procedure Load
| ModifierComboId |
NULL |
CMS CJR Part B Claim Procedure Load
| ModifierComboId |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| ModifierComboId |
NULL |
Data Aggregation ICD Procedure Load
| ModifierComboId |
NULL |
Data Aggregation Service Line Load
| ModifierComboId |
|
||||
Externally Adjudicated ICD Procedure Load
| ModifierComboId |
NULL |
Externally Adjudicated Service Line Load
| ModifierComboId |
|
||||
Payer System ICD Procedure Load
| ModifierComboId |
NULL |
Payer System Service Line Load
| ModifierComboId |
|
||||
Received Claim ICD Procedure Load
| ModifierComboId |
NULL |
Received Claim Procedure Load
| ModifierComboId |
|
||||
PerformedStartDateKey
: integerFirst date procedure was rendered to the patient
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part A Procedure Files Load
| PerformedStartDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
CMS ACO Part B DME File Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS ACO Part B Physicians File Load
| PerformedStartDate |
|
||
|
If CLM_LINE_FROM_DT < 1/1/1753 or CLM_LINE_FROM_DT = 12/31/9999 then NULL Otherwise CLM_LINE_FROM_DT |
CMS CJR DME Claim Procedure Load
| PerformedStartDate |
|
||
CMS CJR Home Health Claim Procedure Load
| PerformedStartDate |
|
||
CMS CJR Inpatient Claim Procedure Load
| PerformedStartDate |
|
||
CMS CJR Outpatient Claim Procedure Load
| PerformedStartDate |
|
||
CMS CJR Part B Claim Procedure Load
| PerformedStartDate |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| PerformedStartDate |
|
||
CMS CJR Surgical Procedure Load
| PerformedStartDate |
|
||
Data Aggregation ICD Procedure Load
| PerformedStartDate |
|
||
Data Aggregation Service Line Load
| PerformedStartDate |
|
||
|
Time Zone: Unspecified |
Externally Adjudicated ICD Procedure Load
| PerformedStartDate |
|
||
Externally Adjudicated Service Line Load
| PerformedStartDate |
|
||
|
Time Zone: Unspecified |
Payer System ICD Procedure Load
| PerformedStartDate |
|
||
Payer System Service Line Load
| PerformedStartDate |
|
||
|
Time Zone: Unspecified |
Received Claim ICD Procedure Load
| PerformedStartDate |
|
||
Received Claim Procedure Load
| PerformedStartDate |
|
||
|
Time Zone: Unspecified |
PerformedEndDateKey
: integerLast date procedure was rendered to the patient
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PerformedEndDate |
|
||
|
If CLM_LINE_THRU_DT < 1/1/1753 or CLM_LINE_THRU_DT = 12/31/9999 then NULL Otherwise CLM_LINE_THRU_DT |
CMS ACO Part A Procedure Files Load
| PerformedEndDate |
|
||
|
If CLM_PRCDR_PRFRM_DT < 1/1/1753 or CLM_PRCDR_PRFRM_DT = 12/31/9999 then NULL Otherwise CLM_PRCDR_PRFRM_DT |
CMS ACO Part B DME File Load
| PerformedEndDate |
|
||
|
If CLM_LINE_THRU_DT < 1/1/1753 or CLM_LINE_THRU_DT = 12/31/9999 then NULL Otherwise CLM_LINE_THRU_DT |
CMS ACO Part B Physicians File Load
| PerformedEndDate |
|
||
|
If CLM_LINE_THRU_DT < 1/1/1753 or CLM_LINE_THRU_DT = 12/31/9999 then NULL Otherwise CLM_LINE_THRU_DT |
CMS CJR DME Claim Procedure Load
| PerformedEndDate |
|
||
CMS CJR Home Health Claim Procedure Load
| PerformedEndDate |
|
||
CMS CJR Inpatient Claim Procedure Load
| PerformedEndDate |
|
||
CMS CJR Outpatient Claim Procedure Load
| PerformedEndDate |
|
||
CMS CJR Part B Claim Procedure Load
| PerformedEndDate |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| PerformedEndDate |
|
||
CMS CJR Surgical Procedure Load
| PerformedEndDate |
|
||
Data Aggregation ICD Procedure Load
| PerformedEndDate |
|
||
Data Aggregation Service Line Load
| PerformedEndDate |
|
||
|
Time Zone: Unspecified |
Externally Adjudicated ICD Procedure Load
| PerformedEndDate |
|
||
Externally Adjudicated Service Line Load
| PerformedEndDate |
|
||
|
Time Zone: Unspecified |
Payer System ICD Procedure Load
| PerformedEndDate |
|
||
Payer System Service Line Load
| PerformedEndDate |
|
||
|
Time Zone: Unspecified |
Received Claim ICD Procedure Load
| PerformedEndDate |
|
||
Received Claim Procedure Load
| PerformedEndDate |
|
||
|
Time Zone: Unspecified |
ReceivedDateKey
: integerDate the claim was received
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReceivedDate |
Not Applicable |
CMS ACO Part A Procedure Files Load
| ReceivedDate |
Not Applicable |
CMS ACO Part B DME File Load
| ReceivedDate |
Not Applicable |
CMS ACO Part B Physicians File Load
| ReceivedDate |
Not Applicable |
CMS CJR DME Claim Procedure Load
| ReceivedDate |
CMS CJR Home Health Claim Procedure Load
| ReceivedDate |
CMS CJR Inpatient Claim Procedure Load
| ReceivedDate |
CMS CJR Outpatient Claim Procedure Load
| ReceivedDate |
CMS CJR Part B Claim Procedure Load
| ReceivedDate |
CMS CJR Skilled Nursing Claim Procedure Load
| ReceivedDate |
CMS CJR Surgical Procedure Load
| ReceivedDate |
Data Aggregation ICD Procedure Load
| ReceivedDate |
|
||
|
AP_CLAIM.DATE_RECEIVED |
Data Aggregation Service Line Load
| ReceivedDate |
|
||
|
AP_CLAIM.DATE_RECEIVED |
Externally Adjudicated ICD Procedure Load
| ReceivedDate |
Not Applicable |
Externally Adjudicated Service Line Load
| ReceivedDate |
Not Applicable |
Payer System ICD Procedure Load
| ReceivedDate |
|
||
|
AP_CLAIM.DATE_RECEIVED |
Payer System Service Line Load
| ReceivedDate |
|
||
|
AP_CLAIM.DATE_RECEIVED |
Received Claim ICD Procedure Load
| ReceivedDate |
|
||
|
AP_CLAIM.DATE_RECEIVED |
Received Claim Procedure Load
| ReceivedDate |
|
||
|
AP_CLAIM.DATE_RECEIVED |
CleanDeniedDateKey
: integerDate the claim reached a status of Clean or Denied
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| CleanDeniedDate |
Not Applicable |
CMS ACO Part A Procedure Files Load
| CleanDeniedDate |
Not Applicable |
CMS ACO Part B DME File Load
| CleanDeniedDate |
Not Applicable |
CMS ACO Part B Physicians File Load
| CleanDeniedDate |
Not Applicable |
CMS CJR DME Claim Procedure Load
| CleanDeniedDate |
CMS CJR Home Health Claim Procedure Load
| CleanDeniedDate |
CMS CJR Inpatient Claim Procedure Load
| CleanDeniedDate |
CMS CJR Outpatient Claim Procedure Load
| CleanDeniedDate |
CMS CJR Part B Claim Procedure Load
| CleanDeniedDate |
CMS CJR Skilled Nursing Claim Procedure Load
| CleanDeniedDate |
CMS CJR Surgical Procedure Load
| CleanDeniedDate |
Data Aggregation ICD Procedure Load
| CleanDeniedDate |
Not Applicable |
Data Aggregation Service Line Load
| CleanDeniedDate |
Not Applicable |
Externally Adjudicated ICD Procedure Load
| CleanDeniedDate |
Not Applicable |
Externally Adjudicated Service Line Load
| CleanDeniedDate |
Not Applicable |
Payer System ICD Procedure Load
| CleanDeniedDate |
Not Applicable |
Payer System Service Line Load
| CleanDeniedDate |
Not Applicable |
Received Claim ICD Procedure Load
| CleanDeniedDate |
|
||||
|
If AP_CLAIM.STATUS_C = 3-Denied or 4-Clean then AP_CLAIM.STATUS_DATE |
Received Claim Procedure Load
| CleanDeniedDate |
|
||||
|
If AP_CLAIM.STATUS_C = 3-Denied or 4-Clean then AP_CLAIM.STATUS_DATE |
PaidDateKey
: integerPost date of the check for the claim
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
Data Lineage for Each Package
CMS ACO Part A Files Load
| PaidDate |
Not Applicable |
CMS ACO Part A Procedure Files Load
| PaidDate |
Not Applicable |
CMS ACO Part B DME File Load
| PaidDate |
Not Applicable |
CMS ACO Part B Physicians File Load
| PaidDate |
Not Applicable |
CMS CJR DME Claim Procedure Load
| PaidDate |
CMS CJR Home Health Claim Procedure Load
| PaidDate |
CMS CJR Inpatient Claim Procedure Load
| PaidDate |
CMS CJR Outpatient Claim Procedure Load
| PaidDate |
CMS CJR Part B Claim Procedure Load
| PaidDate |
CMS CJR Skilled Nursing Claim Procedure Load
| PaidDate |
CMS CJR Surgical Procedure Load
| PaidDate |
Data Aggregation ICD Procedure Load
| PaidDate |
|
||||
|
OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Data Aggregation Service Line Load
| PaidDate |
|
||||
|
OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Externally Adjudicated ICD Procedure Load
| PaidDate |
|
||||
|
OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Externally Adjudicated Service Line Load
| PaidDate |
|
||||
|
OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Payer System ICD Procedure Load
| PaidDate |
|
||||
|
OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Payer System Service Line Load
| PaidDate |
|
||||
|
OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Received Claim ICD Procedure Load
| PaidDate |
|
||||||||||
|
If AP_CHECK.POST_DATE is not null then AP_CHECK.POST_DATE Otherwise OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
Received Claim Procedure Load
| PaidDate |
|
||||||||||
|
If AP_CHECK.POST_DATE is not null then AP_CHECK.POST_DATE Otherwise OTHER_PAYOR_INFO.OTH_PAY_INFO_VAL_DT where OTHER_PAYOR_INFO.OTH_PAY_INFO_TY_C = 1 and the claim does not have multiple different paid dates loaded |
IsValidInSequenceThroughDateKey
: integerDate through which the given claim line would have been considered the final valid claim in the sequence. If a claim is the current claim in the sequence, it will have a date of 2173-12-31.
Properties
- Data type
- integer
- SQL Server data type
- bigint
- Allows null
- No
- Default value
- -1
- Delete value
- -3
AdjustmentType
: stringClaim adjustment type
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdjustmentType |
|
||||||||
|
If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode" |
CMS ACO Part A Procedure Files Load
| AdjustmentType |
|
||||||||
|
If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode" |
CMS ACO Part B DME File Load
| AdjustmentType |
|
||||||||
|
If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode" |
CMS ACO Part B Physicians File Load
| AdjustmentType |
|
||||||||
|
If CLM_ADJSMT_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdjustmentTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdjustmentTypeCode" |
CMS CJR DME Claim Procedure Load
| AdjustmentType |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| AdjustmentType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| AdjustmentType |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| AdjustmentType |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| AdjustmentType |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AdjustmentType |
*Not Applicable |
CMS CJR Surgical Procedure Load
| AdjustmentType |
*Not Applicable |
Data Aggregation ICD Procedure Load
| AdjustmentType |
|
||||||||||||
|
If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original" |
Data Aggregation Service Line Load
| AdjustmentType |
|
||||||||||||
|
If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original" |
Externally Adjudicated ICD Procedure Load
| AdjustmentType |
|
||||||||||
|
If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original" |
Externally Adjudicated Service Line Load
| AdjustmentType |
|
||||||||||
|
If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original" |
Payer System ICD Procedure Load
| AdjustmentType |
|
||||||||||||
|
If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original" |
Payer System Service Line Load
| AdjustmentType |
|
||||||||||||
|
If ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if ORIG_OF_ADJUST_CLAIM_ID is not NULL then "Adjustment" Otherwise "Original" |
Received Claim ICD Procedure Load
| AdjustmentType |
|
||||||||||
|
If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original" |
Received Claim Procedure Load
| AdjustmentType |
|
||||||||||
|
If AP_CLAIM.ORIG_REV_CLM_ID is not NULL then "Cancellation" Otherwise if AP_CLAIM_2.CLM_FREQ_CODE_C = 8 then "Cancellation" Otherwise if the right-most character in AP_CLAIM.TYPE_OF_BILL = "8" then "Cancellation" Otherwise if AP_CLAIM.ORIG_ADJST_CLM_ID is not NULL then "Adjustment" Otherwise if AP_CLAIM_2.ORIG_ACT_ADJ_CLM_ID is not NULL then "Adjustment" Otherwise "Original" |
AdmissionTypeCode
: stringRecognized code for the type and priority of services associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmissionTypeCode |
MsspPartAClaimsHeader.CLM_ADMSN_TYPE_CD |
CMS ACO Part A Procedure Files Load
| AdmissionTypeCode |
|
||
CMS ACO Part B DME File Load
| AdmissionTypeCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AdmissionTypeCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| AdmissionTypeCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| AdmissionTypeCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| AdmissionTypeCode |
|
||
CMS CJR Outpatient Claim Procedure Load
| AdmissionTypeCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| AdmissionTypeCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AdmissionTypeCode |
|
||
CMS CJR Surgical Procedure Load
| AdmissionTypeCode |
|
||||
|
If the claim is inpatient or skilled nursing then TYPE_ADM Otherwise *Not Applicable |
Data Aggregation ICD Procedure Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Data Aggregation Service Line Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Externally Adjudicated ICD Procedure Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Externally Adjudicated Service Line Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Payer System ICD Procedure Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Payer System Service Line Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Received Claim ICD Procedure Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
Received Claim Procedure Load
| AdmissionTypeCode |
|
||||
|
If ADMSN_TYP is not NULL then ADMSN_TYP Otherwise ADMISSION_TYPE_C |
AdmissionType
: stringType and priority of services associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmissionType |
|
||||||||
|
If CLM_ADMSN_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdmissionTypeCode" |
CMS ACO Part A Procedure Files Load
| AdmissionType |
|
||||||||
|
If CLM_ADMSN_TYPE_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionTypeCode" then "*Unknown" Otherwise Name where CategoryName = "ClaimAdmissionTypeCode" |
CMS ACO Part B DME File Load
| AdmissionType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AdmissionType |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| AdmissionType |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| AdmissionType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| AdmissionType |
|
||||||||
|
If TYPE_ADM is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimAdmissionTypeCode then *Unknown Otherwise Name where CategoryName = ClaimAdmissionTypeCode |
CMS CJR Outpatient Claim Procedure Load
| AdmissionType |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| AdmissionType |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AdmissionType |
|
||||||||
|
If TYPE_ADM is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimAdmissionTypeCode then *Unknown Otherwise Name where CategoryName = ClaimAdmissionTypeCode |
CMS CJR Surgical Procedure Load
| AdmissionType |
|
||||||||||
|
If the claim is inpatient or skilled nursing: If TYPE_ADM is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ClaimAdmissionTypeCode then *Unknown Otherwise Name where CategoryName = ClaimAdmissionTypeCode Otherwise if the claim is Part B or hospice then *Not Applicable |
Data Aggregation ICD Procedure Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then *Unknown Otherwise NAME |
Data Aggregation Service Line Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME |
Externally Adjudicated ICD Procedure Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then *Unknown Otherwise NAME |
Externally Adjudicated Service Line Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME |
Payer System ICD Procedure Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then *Unknown Otherwise NAME |
Payer System Service Line Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME |
Received Claim ICD Procedure Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then *Unknown Otherwise NAME |
Received Claim Procedure Load
| AdmissionType |
|
||||||
|
If AP_CLAIM.ADMISSION_TYPE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_TYPE.ADMISSION_TYPE_C is NULL then "*Unknown" Otherwise NAME |
AdmissionSourceCode
: stringRecognized code for the source of the referral for the admission associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmissionSourceCode |
|
||
CMS ACO Part A Procedure Files Load
| AdmissionSourceCode |
|
||
CMS ACO Part B DME File Load
| AdmissionSourceCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AdmissionSourceCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| AdmissionSourceCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| AdmissionSourceCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| AdmissionSourceCode |
|
||
CMS CJR Outpatient Claim Procedure Load
| AdmissionSourceCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| AdmissionSourceCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AdmissionSourceCode |
|
||
CMS CJR Surgical Procedure Load
| AdmissionSourceCode |
|
||||
|
If the claim is inpatient or skilled nursing then SRC_ADMS Otherwise *Not Applicable |
Data Aggregation ICD Procedure Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Data Aggregation Service Line Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Externally Adjudicated ICD Procedure Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Externally Adjudicated Service Line Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Payer System ICD Procedure Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Payer System Service Line Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Received Claim ICD Procedure Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
Received Claim Procedure Load
| AdmissionSourceCode |
|
||||
|
If ADMSN_SRC is not NULL then ADMSN_SRC Otherwise ABBR |
AdmissionSource
: stringSource of the referral for the admission associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdmissionSource |
|
||||||||||
|
If CLM_ADMSN_SRC_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CLM_ADMSN_TYPE_CD = 4-Newborn and CategoryName = "ClaimAdmissionSourceCodeNewborn" then "*Unknown" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionSourceCode" then "*Unknown" Otherwise if CLM_ADMSN_TYPE_CD = 4-Newborn then Name where CategoryName = "ClaimAdmissionSourceCodeNewborn" Otherwise Name where CategoryName = "ClaimAdmissionSourceCode" |
CMS ACO Part A Procedure Files Load
| AdmissionSource |
|
||||||||||
|
If CLM_ADMSN_SRC_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CLM_ADMSN_TYPE_CD = 4-Newborn and CategoryName = "ClaimAdmissionSourceCodeNewborn" then "*Unknown" Otherwise if Id is NULL where CategoryName = "ClaimAdmissionSourceCode" then "*Unknown" Otherwise if CLM_ADMSN_TYPE_CD = 4-Newborn then Name where CategoryName = "ClaimAdmissionSourceCodeNewborn" Otherwise Name where CategoryName = "ClaimAdmissionSourceCode" |
CMS ACO Part B DME File Load
| AdmissionSource |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AdmissionSource |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| AdmissionSource |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| AdmissionSource |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| AdmissionSource |
|
||||||||||
|
If SRC_ADMS is NULL then *Unspecified Otherwise if Id is NULL where TYPE_ADM = 4-Newborn and CategoryName = ClaimAdmissionSourceCodeNewborn then *Unknown Otherwise if Id is NULL where CategoryName = ClaimAdmissionSourceCode then *Unknown Otherwise if TYPE_ADM = 4-Newborn then Name where CategoryName = ClaimAdmissionSourceCodeNewborn Otherwise Name where CategoryName = ClaimAdmissionSourceCode |
CMS CJR Outpatient Claim Procedure Load
| AdmissionSource |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| AdmissionSource |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AdmissionSource |
|
||||||||||
|
If SRC_ADMS is NULL then *Unspecified Otherwise if Id is NULL where TYPE_ADM = 4-Newborn and CategoryName = ClaimAdmissionSourceCodeNewborn then *Unknown Otherwise if Id is NULL where CategoryName = ClaimAdmissionSourceCode then *Unknown Otherwise if TYPE_ADM = 4-Newborn then Name where CategoryName = ClaimAdmissionSourceCodeNewborn Otherwise Name where CategoryName = ClaimAdmissionSourceCode |
CMS CJR Surgical Procedure Load
| AdmissionSource |
|
||||||||||||||
|
If the claim is inpatient or skilled nursing: If SRC_ADMS is NULL then *Unspecified Otherwise if Id is NULL where TYPE_ADM = 4-Newborn and CategoryName = ClaimAdmissionSourceCodeNewborn then *Unknown Otherwise if Id is NULL where CategoryName = ClaimAdmissionSourceCode then *Unknown Otherwise if TYPE_ADM = 4-Newborn then Name where CategoryName = ClaimAdmissionSourceCodeNewborn Otherwise Name where CategoryName = ClaimAdmissionSourceCode Otherwise if the claim is Part B or hospice then *Not Applicable |
Data Aggregation ICD Procedure Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then *Unknown Otherwise NAME |
Data Aggregation Service Line Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME |
Externally Adjudicated ICD Procedure Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then *Unknown Otherwise NAME |
Externally Adjudicated Service Line Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME |
Payer System ICD Procedure Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then *Unknown Otherwise NAME |
Payer System Service Line Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME |
Received Claim ICD Procedure Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then *Unspecified Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then *Unknown Otherwise NAME |
Received Claim Procedure Load
| AdmissionSource |
|
||||||
|
If AP_CLAIM.ADMISSION_SOURCE_C is NULL then "*Unspecified" Otherwise if ZC_MC_ADM_SOURCE.ADMISSION_SOURCE_C is NULL then "*Unknown" Otherwise NAME |
DenialReason
: stringClaim denial reason
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DenialReason |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| DenialReason |
"*Not Applicable" |
CMS ACO Part B DME File Load
| DenialReason |
|
||||||||||
|
If CLM_PRCSG_IND_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimLineProcessingIndicatorCode" then "*Unknown" Otherwise if IsDenial = 0 then "*Not Applicable" Otherwise Name where CategoryName = "ClaimLineProcessingIndicatorCode" |
CMS ACO Part B Physicians File Load
| DenialReason |
|
||||||||||
|
If CLM_PRCSG_IND_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimLineProcessingIndicatorCode" then "*Unknown" Otherwise if IsDenial = 0 then "*Not Applicable" Otherwise Name where CategoryName = "ClaimLineProcessingIndicatorCode" |
CMS CJR DME Claim Procedure Load
| DenialReason |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| DenialReason |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| DenialReason |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| DenialReason |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| DenialReason |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| DenialReason |
*Not Applicable |
CMS CJR Surgical Procedure Load
| DenialReason |
*Not Applicable |
Data Aggregation Service Line Load
| DenialReason |
|
||||
|
IF PRCS_IND_CD is not null and PRCS_IND_CD_DESC is null then *Unknown Otherwise if PRCS_IND_CD_DESC is not null then PRCS_IND_CD_DESC Otherwise if STATUS_C = 3 then "Denied" Otherwise "*Not Applicable" |
Externally Adjudicated ICD Procedure Load
| DenialReason |
|
||||||||||
|
If CLM_VALUES_5.NON_PAYMENT_RSN_CD is not null and CLM_VALUES_5.NON_PAYMENT_RSN_DESC is null then ''*Unknown''' Otherwise if CLM_VALUES_5.CARRIER_PAYMENT_DNL_CD is not null and CLM_VALUES_5.CARRIER_PAYMENT_DNL_DESC is null then ''*Unknown''' Otherwise if CLM_VALUES_5.NON_PAYMENT_RSN_DESC is not null then CLM_VALUES_5.NON_PAYMENT_RSN_CD' Otherwise if CLM_VALUES_5.CARRIER_PAYMENT_DNL_DESC is not null then CLM_VALUES_5.CARRIER_PAYMENT_DNL_DESC' Otherwise if STATUS_C = 3 - Denied then "Denied" Otherwise "*Not Applicable" |
Externally Adjudicated Service Line Load
| DenialReason |
|
||||||
|
If SVC_LN_INFO_3.PRCS_IND_CD is not null and SVC_LN_INFO_3.PRCS_IND_CD_DESC is null then ''*Unknown''' Otherwise if SVC_LN_INFO_3.PRCS_IND_CD_DESC is not null then SVC_LN_INFO_3.PRCS_IND_CD_DESC' Otherwise if STATUS_C = 3 - Denied then "Denied" Otherwise "*Not Applicable" |
Payer System Service Line Load
| DenialReason |
|
||||
|
IF PRCS_IND_CD is not null and PRCS_IND_CD_DESC is null then *Unknown Otherwise if PRCS_IND_CD_DESC is not null then PRCS_IND_CD_DESC Otherwise if STATUS_C = 3 then "Denied" Otherwise "*Not Applicable" |
Received Claim ICD Procedure Load
| DenialReason |
|
||
|
If STATUS_C = 3 - Denied then Denied Otherwise *Not Applicable |
Received Claim Procedure Load
| DenialReason |
|
||
|
If STATUS_C = 3 - Denied then Denied Otherwise "*Not Applicable" |
DrgType
: stringClaim Diagnosis Related Group (DRG) type
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DrgType |
This column isn't configured for use in reports. See an administrator for more information. |
CMS ACO Part A Procedure Files Load
| DrgType |
This column isn't configured for use in reports. See an administrator for more information. |
CMS ACO Part B DME File Load
| DrgType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| DrgType |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| DrgType |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| DrgType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| DrgType |
This column isn't configured for use in reports. See an administrator for more information. |
CMS CJR Outpatient Claim Procedure Load
| DrgType |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| DrgType |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| DrgType |
This column isn't configured for use in reports. See an administrator for more information. |
CMS CJR Surgical Procedure Load
| DrgType |
If the claim is inpatient or skilled nursing then *Unspecified Otherwise If the claim is Part B or hospice then *Not Applicable |
Data Aggregation ICD Procedure Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Data Aggregation Service Line Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Externally Adjudicated ICD Procedure Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Externally Adjudicated Service Line Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Payer System ICD Procedure Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Payer System Service Line Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Received Claim ICD Procedure Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
Received Claim Procedure Load
| DrgType |
|
||||
|
If ID_TYPE_NAME is not NULL for DRG_ID_TYPE_ID then ID_TYPE_NAME Otherwise "*Unspecified" |
DrgCode
: stringClaim Diagnosis Related Group (DRG) code
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DrgCode |
|
||
CMS ACO Part A Procedure Files Load
| DrgCode |
|
||
CMS ACO Part B DME File Load
| DrgCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| DrgCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| DrgCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| DrgCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| DrgCode |
|
||
CMS CJR Outpatient Claim Procedure Load
| DrgCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| DrgCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| DrgCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| DrgCode |
|
||||
|
If the claim is inpatient or skilled nursing then DRG_CD Otherwise *Not Applicable |
Data Aggregation ICD Procedure Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Data Aggregation Service Line Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Externally Adjudicated ICD Procedure Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Externally Adjudicated Service Line Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Payer System ICD Procedure Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Payer System Service Line Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Received Claim ICD Procedure Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
Received Claim Procedure Load
| DrgCode |
|
||||||
|
If DRG_ID_TYPE_ID is not NULL then MPI_ID for DRG_ID_TYPE_ID Otherwise MPI_ID for DRG_ID |
IsDrg
: integer1/0 column that indicates whether the record stores DRG information used for pricing instead of a service or procedure. This column returns 1 if the record stores DRG information used for pricing and 0 if the record represents a service line or procedure.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 0
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsDrg |
0 |
CMS ACO Part A Procedure Files Load
| IsDrg |
0 |
CMS ACO Part B DME File Load
| IsDrg |
0 |
CMS ACO Part B Physicians File Load
| IsDrg |
0 |
CMS CJR DME Claim Procedure Load
| IsDrg |
CMS CJR Home Health Claim Procedure Load
| IsDrg |
CMS CJR Inpatient Claim Procedure Load
| IsDrg |
CMS CJR Outpatient Claim Procedure Load
| IsDrg |
CMS CJR Part B Claim Procedure Load
| IsDrg |
CMS CJR Skilled Nursing Claim Procedure Load
| IsDrg |
CMS CJR Surgical Procedure Load
| IsDrg |
Data Aggregation ICD Procedure Load
| IsDrg |
0 |
Data Aggregation Service Line Load
| IsDrg |
|
||
|
If TX_TYPE_C = 6 - AP Claim DRG Tx then 1 Otherwise 0 |
Externally Adjudicated ICD Procedure Load
| IsDrg |
0 |
Externally Adjudicated Service Line Load
| IsDrg |
|
||
|
If TX_TYPE_C = 6 - AP Claim DRG Tx then 1 Otherwise 0 |
Payer System ICD Procedure Load
| IsDrg |
0 |
Payer System Service Line Load
| IsDrg |
|
||
|
If TX_TYPE_C = 6 - AP Claim DRG Tx then 1 Otherwise 0 |
Received Claim ICD Procedure Load
| IsDrg |
0 |
Received Claim Procedure Load
| IsDrg |
|
||
|
If TX_TYPE_C = 6 - AP Claim DRG Tx then 1 Otherwise 0 |
IsServicePricedByDrg
: integer1/0 column that indicates whether the record is a service priced using a DRG. This column returns 1 if the record is a service known to be priced using a DRG and 0 if the record is not known to be priced using a DRG or if the record stores DRG information used for pricing instead of a service or procedure.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 0
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsServicePricedByDrg |
0 |
CMS ACO Part A Procedure Files Load
| IsServicePricedByDrg |
0 |
CMS ACO Part B DME File Load
| IsServicePricedByDrg |
0 |
CMS ACO Part B Physicians File Load
| IsServicePricedByDrg |
0 |
CMS CJR DME Claim Procedure Load
| IsServicePricedByDrg |
CMS CJR Home Health Claim Procedure Load
| IsServicePricedByDrg |
CMS CJR Inpatient Claim Procedure Load
| IsServicePricedByDrg |
CMS CJR Outpatient Claim Procedure Load
| IsServicePricedByDrg |
CMS CJR Part B Claim Procedure Load
| IsServicePricedByDrg |
CMS CJR Skilled Nursing Claim Procedure Load
| IsServicePricedByDrg |
CMS CJR Surgical Procedure Load
| IsServicePricedByDrg |
Data Aggregation ICD Procedure Load
| IsServicePricedByDrg |
0 |
Data Aggregation Service Line Load
| IsServicePricedByDrg |
|
||||||||||||
|
If DRG_PRICING_YN is NULL then 0 Otherwise if DRG_PRICING_YN = 'N' then 0 Otherwise if TX_TYPE_C = 6 then 0 Otherwise if REDISTRIBUTED_TO_TX_ID is NULL then 1 Otherwise if the transaction pointed to by REDISTRIBUTED_TO_TX_ID is on the same claim and has TX_TYPE_C = 6 then 1 Otherwise 0 |
Externally Adjudicated ICD Procedure Load
| IsServicePricedByDrg |
0 |
Externally Adjudicated Service Line Load
| IsServicePricedByDrg |
|
||||||||||||
|
If DRG_PRICING_YN is NULL then 0 Otherwise if DRG_PRICING_YN = 'N' then 0 Otherwise if TX_TYPE_C = 6 then 0 Otherwise if REDISTRIBUTED_TO_TX_ID is NULL then 1 Otherwise if the transaction pointed to by REDISTRIBUTED_TO_TX_ID is on the same claim and has TX_TYPE_C = 6 then 1 Otherwise 0 |
Payer System ICD Procedure Load
| IsServicePricedByDrg |
0 |
Payer System Service Line Load
| IsServicePricedByDrg |
|
||||||||||||
|
If DRG_PRICING_YN is NULL then 0 Otherwise if DRG_PRICING_YN = 'N' then 0 Otherwise if TX_TYPE_C = 6 then 0 Otherwise if REDISTRIBUTED_TO_TX_ID is NULL then 1 Otherwise if the transaction pointed to by REDISTRIBUTED_TO_TX_ID is on the same claim and has TX_TYPE_C = 6 then 1 Otherwise 0 |
Received Claim ICD Procedure Load
| IsServicePricedByDrg |
0 |
Received Claim Procedure Load
| IsServicePricedByDrg |
|
||||||||||||
|
If DRG_PRICING_YN is NULL then 0 Otherwise if DRG_PRICING_YN = 'N' then 0 Otherwise if TX_TYPE_C = 6 then 0 Otherwise if REDISTRIBUTED_TO_TX_ID is NULL then 1 Otherwise if the transaction pointed to by REDISTRIBUTED_TO_TX_ID is on the same claim and has TX_TYPE_C = 6 then 1 Otherwise 0 |
DischargeDispositionCode
: stringRecognized code for the discharge disposition of the patient associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DischargeDispositionCode |
|
||
CMS ACO Part A Procedure Files Load
| DischargeDispositionCode |
|
||
CMS ACO Part B DME File Load
| DischargeDispositionCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| DischargeDispositionCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| DischargeDispositionCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| DischargeDispositionCode |
|
||
CMS CJR Inpatient Claim Procedure Load
| DischargeDispositionCode |
|
||
CMS CJR Outpatient Claim Procedure Load
| DischargeDispositionCode |
|
||
CMS CJR Part B Claim Procedure Load
| DischargeDispositionCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| DischargeDispositionCode |
|
||
CMS CJR Surgical Procedure Load
| DischargeDispositionCode |
|
||||||
|
If the claim is inpatient, skilled nursing, or hospice then STUS_CD Otherwise *Not Applicable |
Data Aggregation ICD Procedure Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Data Aggregation Service Line Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Externally Adjudicated ICD Procedure Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Externally Adjudicated Service Line Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Payer System ICD Procedure Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Payer System Service Line Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Received Claim ICD Procedure Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
Received Claim Procedure Load
| DischargeDispositionCode |
|
||||
|
If DISCHRG_DISP is not NULL then DISCHRG_DISP Otherwise PAT_STATUS_C |
DischargeDisposition
: stringPatient discharge disposition
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DischargeDisposition |
|
||||||||
|
If BENE_PTNT_STUS_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "BeneficiaryPatientStatusCode" then "*Unknown" Otherwise Name where CategoryName = "BeneficiaryPatientStatusCode" |
CMS ACO Part A Procedure Files Load
| DischargeDisposition |
|
||||||||
|
If BENE_PTNT_STUS_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "BeneficiaryPatientStatusCode" then "*Unknown" Otherwise Name where CategoryName = "BeneficiaryPatientStatusCode" |
CMS ACO Part B DME File Load
| DischargeDisposition |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| DischargeDisposition |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| DischargeDisposition |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| DischargeDisposition |
|
||||||||
|
If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name |
CMS CJR Inpatient Claim Procedure Load
| DischargeDisposition |
|
||||||||
|
If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name |
CMS CJR Outpatient Claim Procedure Load
| DischargeDisposition |
|
||||||||
|
If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name |
CMS CJR Part B Claim Procedure Load
| DischargeDisposition |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| DischargeDisposition |
|
||||||||
|
If STUS_CD is NULL then *Unspecified If Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name |
CMS CJR Surgical Procedure Load
| DischargeDisposition |
|
||||||||||||
|
If the claim is inpatient, skilled nursing, or hospice: If STUS_CD is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = BeneficiaryPatientStatusCode then *Unknown Otherwise Name where CategoryName = BeneficiaryPatientStatusCode Otherwise if the claim is Part B then *Not Applicable |
Data Aggregation ICD Procedure Load
| DischargeDisposition |
|
||||||
|
If AP_CLAIM.PAT_STATUS_C is NULL then *Unspecified Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then *Unknown Otherwise NAME |
Data Aggregation Service Line Load
| DischargeDisposition |
|
||||||
Externally Adjudicated ICD Procedure Load
| DischargeDisposition |
|
||||||
|
If AP_CLAIM.PAT_STATUS_C is NULL then *Unspecified Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then *Unknown Otherwise NAME |
Externally Adjudicated Service Line Load
| DischargeDisposition |
|
||||||
|
If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME |
Payer System ICD Procedure Load
| DischargeDisposition |
|
||||||
|
If AP_CLAIM.PAT_STATUS_C is NULL then *Unspecified Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then *Unknown Otherwise NAME |
Payer System Service Line Load
| DischargeDisposition |
|
||||||
|
If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME |
Received Claim ICD Procedure Load
| DischargeDisposition |
|
||||||
|
If AP_CLAIM.PAT_STATUS_C is NULL then *Unspecified Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then *Unknown Otherwise NAME |
Received Claim Procedure Load
| DischargeDisposition |
|
||||||
|
If AP_CLAIM.PAT_STATUS_C is NULL then "*Unspecified" Otherwise if ZC_MC_PAT_STATUS.PAT_STATUS_C is NULL then "*Unknown" Otherwise NAME |
InterpretedClaimDetailType
: stringClaim type interpreted from the type of bill, procedure, revenue, and place of service codes
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| InterpretedClaimDetailType |
NULL |
CMS ACO Part A Procedure Files Load
| InterpretedClaimDetailType |
NULL |
CMS ACO Part B DME File Load
| InterpretedClaimDetailType |
NULL |
CMS ACO Part B Physicians File Load
| InterpretedClaimDetailType |
NULL |
CMS CJR DME Claim Procedure Load
| InterpretedClaimDetailType |
NULL |
CMS CJR Home Health Claim Procedure Load
| InterpretedClaimDetailType |
NULL |
CMS CJR Inpatient Claim Procedure Load
| InterpretedClaimDetailType |
NULL |
CMS CJR Outpatient Claim Procedure Load
| InterpretedClaimDetailType |
NULL |
CMS CJR Part B Claim Procedure Load
| InterpretedClaimDetailType |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| InterpretedClaimDetailType |
NULL |
CMS CJR Surgical Procedure Load
| InterpretedClaimDetailType |
NULL |
Data Aggregation ICD Procedure Load
| InterpretedClaimDetailType |
NULL |
Data Aggregation Service Line Load
| InterpretedClaimDetailType |
NULL |
Externally Adjudicated ICD Procedure Load
| InterpretedClaimDetailType |
NULL |
Externally Adjudicated Service Line Load
| InterpretedClaimDetailType |
NULL |
Payer System ICD Procedure Load
| InterpretedClaimDetailType |
NULL |
Payer System Service Line Load
| InterpretedClaimDetailType |
NULL |
Received Claim ICD Procedure Load
| InterpretedClaimDetailType |
NULL |
Received Claim Procedure Load
| InterpretedClaimDetailType |
NULL |
RevenueCode
: stringRevenue code associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RevenueCode |
|
||
CMS ACO Part A Procedure Files Load
| RevenueCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RevenueCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RevenueCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| RevenueCode |
NotApplicable |
CMS CJR Home Health Claim Procedure Load
| RevenueCode |
|
||
CMS CJR Inpatient Claim Procedure Load
| RevenueCode |
|
||
CMS CJR Outpatient Claim Procedure Load
| RevenueCode |
|
||
CMS CJR Part B Claim Procedure Load
| RevenueCode |
NotApplicable |
CMS CJR Skilled Nursing Claim Procedure Load
| RevenueCode |
|
||
CMS CJR Surgical Procedure Load
| RevenueCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| RevenueCode |
*Not Applicable |
Data Aggregation Service Line Load
| RevenueCode |
|
||||
|
If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then LN_REV_CD |
Externally Adjudicated ICD Procedure Load
| RevenueCode |
*Not Applicable |
Externally Adjudicated Service Line Load
| RevenueCode |
|
||||
|
If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise LN_REV_CD |
Payer System ICD Procedure Load
| RevenueCode |
*Not Applicable |
Payer System Service Line Load
| RevenueCode |
|
||||
|
If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then LN_REV_CD |
Received Claim ICD Procedure Load
| RevenueCode |
*Not Applicable |
Received Claim Procedure Load
| RevenueCode |
|
||||||||||
|
If REVENUE_CODE is not NULL then REVENUE_CODE Otherwise if the number of services has not been modified in the system then LN_REV_CD |
ProcedureCodeType
: stringProcedure code type
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ProcedureCodeType |
|
||
|
"HippsCode" if CLM_LINE_PROD_REV_CTR_CD is 0022, 0023, or 0024; otherwise "HcpcsCode" |
CMS ACO Part A Procedure Files Load
| ProcedureCodeType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-PCS" Otherwise "Unknown Code Type" |
CMS ACO Part B DME File Load
| ProcedureCodeType |
"HcpcsCode" |
CMS ACO Part B Physicians File Load
| ProcedureCodeType |
"HcpcsCode" |
CMS CJR DME Claim Procedure Load
| ProcedureCodeType |
HcpcsCode |
CMS CJR Home Health Claim Procedure Load
| ProcedureCodeType |
HcpcsCode |
CMS CJR Inpatient Claim Procedure Load
| ProcedureCodeType |
HcpcsCode |
CMS CJR Outpatient Claim Procedure Load
| ProcedureCodeType |
HcpcsCode |
CMS CJR Part B Claim Procedure Load
| ProcedureCodeType |
HcpcsCode |
CMS CJR Skilled Nursing Claim Procedure Load
| ProcedureCodeType |
HcpcsCode |
CMS CJR Surgical Procedure Load
| ProcedureCodeType |
|
||||||||||||||||||||
|
If claim is inpatient or skilled nursing: If DGNS_PRCDR_ICD_IND = 9-ICD-9 or DSCHRGDT < 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT < 2015-10-01 ) then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and ( DSCHRGDT >= 2015-10-01 or ( DSCHRGDT is NULL and CLM_THRU_DT >= 2015-10-01 ) ) then ICD-10-PCS Otherwise Unspecified Otherwise if the claim is Part B or hospice: If no CODE_VALUE for this claim where CLM_PROD_TYPE_CD = S-Procedure exists then HcpcsCode Otherwise If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-PCS Otherwise Unspecified |
Data Aggregation ICD Procedure Load
| ProcedureCodeType |
|
||||||||
|
If REF_BILL_CODE_SET_C is NULL then *Unspecified Otherwise if REF_BILL_CODE_SET_C = 1 - ICD-9-CM Volume 3 then ICD-9-CM Otherwise if REF_BILL_CODE_SET_C = 2 - ICD-10-PCS then ICD-10-PCS Otherwise if CODE_SET_C is NULL then *Unknown Otherwise NAME |
Data Aggregation Service Line Load
| ProcedureCodeType |
|
||||||||||
|
If CODE_TYPE_C = 1 or 2 then "HcpcsCode" Otherwise if CODE_TYPE_C is NULL and PROC_ID is not NULL then "HcpcsCode" Otherwise if CPT_CODE is not NULL then "OtherCode" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HcpcsCode' Otherwise if LN_PROC_QUAL = "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HippsCode' |
Externally Adjudicated ICD Procedure Load
| ProcedureCodeType |
|
||||||||
|
If REF_BILL_CODE_SET_C is NULL then *Unspecified Otherwise if REF_BILL_CODE_SET_C = 1 - ICD-9-CM Volume 3 then ICD-9-CM Otherwise if REF_BILL_CODE_SET_C = 2 - ICD-10-PCS then ICD-10-PCS Otherwise if CODE_SET_C is NULL then *Unknown Otherwise NAME |
Externally Adjudicated Service Line Load
| ProcedureCodeType |
|
||||||||||
|
If CODE_TYPE_C = 1 - CPT(R) or 2 - HCPCS or NULL for PROC_ID then "HcpcsCode" Otherwise if PROC_ID is not NULL then "OtherCode" Otherwise "HcpcsCode" |
Payer System ICD Procedure Load
| ProcedureCodeType |
|
||||||||
|
If REF_BILL_CODE_SET_C is NULL then *Unspecified Otherwise if REF_BILL_CODE_SET_C = 1 - ICD-9-CM Volume 3 then ICD-9-CM Otherwise if REF_BILL_CODE_SET_C = 2 - ICD-10-PCS then ICD-10-PCS Otherwise if CODE_SET_C is NULL then *Unknown Otherwise NAME |
Payer System Service Line Load
| ProcedureCodeType |
|
||||||||||
|
If CODE_TYPE_C = 1 or 2 then "HcpcsCode" Otherwise if CODE_TYPE_C is NULL and PROC_ID is not NULL then "HcpcsCode" Otherwise if CPT_CODE is not NULL then "OtherCode" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HcpcsCode' Otherwise if LN_PROC_QUAL = "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HippsCode' |
Received Claim ICD Procedure Load
| ProcedureCodeType |
|
||||||||
|
If REF_BILL_CODE_SET_C is NULL then *Unspecified Otherwise if REF_BILL_CODE_SET_C = 1 - ICD-9-CM Volume 3 then ICD-9-CM Otherwise if REF_BILL_CODE_SET_C = 2 - ICD-10-PCS then ICD-10-PCS Otherwise if CODE_SET_C is NULL then *Unknown Otherwise NAME |
Received Claim Procedure Load
| ProcedureCodeType |
|
||||||||||||||||
|
If CODE_TYPE_C = 1 or 2 then "HcpcsCode" Otherwise if CODE_TYPE_C is NULL and PROC_ID is not NULL then "HcpcsCode" Otherwise if CPT_CODE is not NULL then "OtherCode" Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HcpcsCode' Otherwise if LN_PROC_QUAL = "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then 'HippsCode' |
ProcedureCode
: stringProcedure code
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ProcedureCode |
|
||
CMS ACO Part A Procedure Files Load
| ProcedureCode |
|
||
CMS ACO Part B DME File Load
| ProcedureCode |
|
||
CMS ACO Part B Physicians File Load
| ProcedureCode |
|
||
CMS CJR DME Claim Procedure Load
| ProcedureCode |
|
||
CMS CJR Home Health Claim Procedure Load
| ProcedureCode |
|
||
CMS CJR Inpatient Claim Procedure Load
| ProcedureCode |
|
||
CMS CJR Outpatient Claim Procedure Load
| ProcedureCode |
|
||
CMS CJR Part B Claim Procedure Load
| ProcedureCode |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| ProcedureCode |
|
||
CMS CJR Surgical Procedure Load
| ProcedureCode |
|
||
Data Aggregation ICD Procedure Load
| ProcedureCode |
|
||||
Data Aggregation Service Line Load
| ProcedureCode |
|
||||||
|
If CPT_CODE for PROC_ID is not NULL the CPT_CODE Otherwise if LN_PROC_QUAL = "HC" or "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
Externally Adjudicated ICD Procedure Load
| ProcedureCode |
|
||||
Externally Adjudicated Service Line Load
| ProcedureCode |
|
||||||||
|
If CPT_CODE for PROC_ID is not NULL the CPT_CODE Otherwise if LN_PROC_QUAL = "HC" and LN_PROC_CD is not NULL then LN_PROC_CD |
Payer System ICD Procedure Load
| ProcedureCode |
|
||||
Payer System Service Line Load
| ProcedureCode |
|
||||||
|
If CPT_CODE for PROC_ID is not NULL the CPT_CODE Otherwise if LN_PROC_QUAL = "HC" or "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
Received Claim ICD Procedure Load
| ProcedureCode |
|
||||
Received Claim Procedure Load
| ProcedureCode |
|
||||||||||||||
|
If CPT_CODE for PROC_ID is not NULL the CPT_CODE Otherwise if LN_PROC_QUAL = "HC" or "HP" and LN_PROC_CD is not NULL and the number of services has not been modified in the system then LN_PROC_CD |
PlaceOfServiceType
: stringCenters for Medicare & Medicaid Services (CMS) name for the place of service where the procedure was performed
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| PlaceOfServiceType |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| PlaceOfServiceType |
"*Not Applicable" |
CMS ACO Part B DME File Load
| PlaceOfServiceType |
|
||||||||
|
If CLM_POS_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "PlaceOfServiceCode" then "*Unknown" Otherwise Name where CategoryName = "PlaceOfServiceCode" |
CMS ACO Part B Physicians File Load
| PlaceOfServiceType |
|
||||||||
|
If CLM_POS_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "PlaceOfServiceCode" then "*Unknown" Otherwise Name where CategoryName = "PlaceOfServiceCode" |
CMS CJR DME Claim Procedure Load
| PlaceOfServiceType |
|
||||||||
|
If PLCSRVC is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = PlaceOfServiceCode then *Unknown Otherwise Name where CategoryName = PlaceOfServiceCode |
CMS CJR Home Health Claim Procedure Load
| PlaceOfServiceType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| PlaceOfServiceType |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| PlaceOfServiceType |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| PlaceOfServiceType |
|
||||||||
|
If PLCSRVC is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = PlaceOfServiceCode then *Unknown Otherwise Name where CategoryName = PlaceOfServiceCode |
CMS CJR Skilled Nursing Claim Procedure Load
| PlaceOfServiceType |
*Not Applicable |
CMS CJR Surgical Procedure Load
| PlaceOfServiceType |
*Not Applicable |
Data Aggregation ICD Procedure Load
| PlaceOfServiceType |
*Not Applicable |
Data Aggregation Service Line Load
| PlaceOfServiceType |
|
||||||
|
If AP_CLAIM_PROC.POS_TYPE_C IS NULL THEN "*Unspecified" Otherwise if ZC_POS_TYPE.POS_TYPE_C IS NULL THEN "*Unknown" Otherwise NAME |
Externally Adjudicated ICD Procedure Load
| PlaceOfServiceType |
*Not Applicable |
Externally Adjudicated Service Line Load
| PlaceOfServiceType |
|
||||||
|
If AP_CLAIM_PROC.POS_TYPE_C IS NULL THEN "*Unspecified" Otherwise if ZC_POS_TYPE.POS_TYPE_C IS NULL THEN "*Unknown" Otherwise NAME |
Payer System ICD Procedure Load
| PlaceOfServiceType |
*Not Applicable |
Payer System Service Line Load
| PlaceOfServiceType |
|
||||||
|
If AP_CLAIM_PROC.POS_TYPE_C IS NULL THEN "*Unspecified" Otherwise if ZC_POS_TYPE.POS_TYPE_C IS NULL THEN "*Unknown" Otherwise NAME |
Received Claim ICD Procedure Load
| PlaceOfServiceType |
*Not Applicable |
Received Claim Procedure Load
| PlaceOfServiceType |
|
||||||
|
If AP_CLAIM_PROC.POS_TYPE_C IS NULL THEN "*Unspecified" Otherwise if ZC_POS_TYPE.POS_TYPE_C IS NULL THEN "*Unknown" Otherwise NAME |
ServiceType
: stringService type associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceType |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| ServiceType |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ServiceType |
|
||||||||
|
If CLM_FED_TYPE_SRVC_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "FederalTypeServiceCode" then "*Unknown" Otherwise Name where CategoryName = "FederalTypeServiceCode" |
CMS ACO Part B Physicians File Load
| ServiceType |
|
||||||||
|
If CLM_FED_TYPE_SRVC_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "FederalTypeServiceCode" then "*Unknown" Otherwise Name where CategoryName = "FederalTypeServiceCode" |
CMS CJR DME Claim Procedure Load
| ServiceType |
|
||||||||
|
If TYPSRVCB is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = FederalTypeServiceCode then *Unknown Otherwise Name where CategoryName = FederalTypeServiceCode |
CMS CJR Home Health Claim Procedure Load
| ServiceType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| ServiceType |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| ServiceType |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| ServiceType |
|
||||||||
|
If TYPSRVCB is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = FederalTypeServiceCode then *Unknown Otherwise Name where CategoryName = FederalTypeServiceCode |
CMS CJR Skilled Nursing Claim Procedure Load
| ServiceType |
*Not Applicable |
CMS CJR Surgical Procedure Load
| ServiceType |
*Not Applicable |
Data Aggregation ICD Procedure Load
| ServiceType |
*Not Applicable |
Externally Adjudicated ICD Procedure Load
| ServiceType |
*Not Applicable |
Externally Adjudicated Service Line Load
| ServiceType |
NULL |
Payer System ICD Procedure Load
| ServiceType |
*Not Applicable |
Received Claim ICD Procedure Load
| ServiceType |
*Not Applicable |
Received Claim Procedure Load
| ServiceType |
|
||||||
|
If AP_CLAIM_PROC.TYPE_OF_SERVICE_C IS NULL THEN "*Unspecified" Otherwise if ZC_TYPE_OF_SERVICE.TYPE_OF_SERVICE_C IS NULL THEN "*Unknown" Otherwise NAME |
TypeOfBillCode
: stringType of bill code
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| TypeOfBillCode |
|
||||||
|
Concatenation of CLM_BILL_FAC_TYPE_CD, CLM_BILL_CLSFCTN_CD, and CLM_BILL_FREQ_CD |
CMS ACO Part A Procedure Files Load
| TypeOfBillCode |
|
||||||
|
Concatenation of CLM_BILL_FAC_TYPE_CD, CLM_BILL_CLSFCTN_CD, and CLM_BILL_FREQ_CD |
CMS ACO Part B DME File Load
| TypeOfBillCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| TypeOfBillCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| TypeOfBillCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| TypeOfBillCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| TypeOfBillCode |
|
||
Data Aggregation Service Line Load
| TypeOfBillCode |
|
||
Externally Adjudicated ICD Procedure Load
| TypeOfBillCode |
|
||
Externally Adjudicated Service Line Load
| TypeOfBillCode |
|
||
Payer System ICD Procedure Load
| TypeOfBillCode |
|
||
Payer System Service Line Load
| TypeOfBillCode |
|
||
Received Claim ICD Procedure Load
| TypeOfBillCode |
|
||
Received Claim Procedure Load
| TypeOfBillCode |
|
||
FirstModifier
: stringFirst modifier associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FirstModifier |
|
||
CMS ACO Part A Procedure Files Load
| FirstModifier |
"*Not Applicable" |
CMS ACO Part B DME File Load
| FirstModifier |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FirstModifier |
|
||
CMS CJR DME Claim Procedure Load
| FirstModifier |
|
||
CMS CJR Home Health Claim Procedure Load
| FirstModifier |
|
||
CMS CJR Inpatient Claim Procedure Load
| FirstModifier |
|
||
CMS CJR Outpatient Claim Procedure Load
| FirstModifier |
|
||
CMS CJR Part B Claim Procedure Load
| FirstModifier |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| FirstModifier |
|
||
CMS CJR Surgical Procedure Load
| FirstModifier |
*Not Applicable |
Data Aggregation ICD Procedure Load
| FirstModifier |
*Not Applicable |
Data Aggregation Service Line Load
| FirstModifier |
|
||||
|
If MODIFIERS is not NULL then first modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the first modifier in the comma delimited list of LN_PROC_MOD |
Externally Adjudicated ICD Procedure Load
| FirstModifier |
*Not Applicable |
Externally Adjudicated Service Line Load
| FirstModifier |
|
||||
|
If MODIFIERS is not NULL then first modifier in the comma delimited list of MODIFIERS Otherwise the first modifier in the comma delimited list of LN_PROC_MOD |
Payer System ICD Procedure Load
| FirstModifier |
*Not Applicable |
Payer System Service Line Load
| FirstModifier |
|
||||
|
If MODIFIERS is not NULL then first modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the first modifier in the comma delimited list of LN_PROC_MOD |
Received Claim ICD Procedure Load
| FirstModifier |
*Not Applicable |
Received Claim Procedure Load
| FirstModifier |
|
||||||||||
|
If MODIFIERS is not NULL then first modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the first modifier in the comma delimited list of LN_PROC_MOD |
SecondModifier
: stringSecond modifier associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SecondModifier |
|
||
CMS ACO Part A Procedure Files Load
| SecondModifier |
"*Not Applicable" |
CMS ACO Part B DME File Load
| SecondModifier |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SecondModifier |
|
||
CMS CJR DME Claim Procedure Load
| SecondModifier |
|
||
CMS CJR Home Health Claim Procedure Load
| SecondModifier |
|
||
CMS CJR Inpatient Claim Procedure Load
| SecondModifier |
|
||
CMS CJR Outpatient Claim Procedure Load
| SecondModifier |
|
||
CMS CJR Part B Claim Procedure Load
| SecondModifier |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| SecondModifier |
|
||
CMS CJR Surgical Procedure Load
| SecondModifier |
*Not Applicable |
Data Aggregation ICD Procedure Load
| SecondModifier |
*Not Applicable |
Data Aggregation Service Line Load
| SecondModifier |
|
||||
|
If MODIFIERS is not NULL then second modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the second modifier in the comma delimited list of LN_PROC_MOD |
Externally Adjudicated ICD Procedure Load
| SecondModifier |
*Not Applicable |
Externally Adjudicated Service Line Load
| SecondModifier |
|
||||
|
If MODIFIERS is not NULL then second modifier in the comma delimited list of MODIFIERS Otherwise the second modifier in the comma delimited list of LN_PROC_MOD |
Payer System ICD Procedure Load
| SecondModifier |
*Not Applicable |
Payer System Service Line Load
| SecondModifier |
|
||||
|
If MODIFIERS is not NULL then second modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the second modifier in the comma delimited list of LN_PROC_MOD |
Received Claim ICD Procedure Load
| SecondModifier |
*Not Applicable |
Received Claim Procedure Load
| SecondModifier |
|
||||||||||
|
If MODIFIERS is not NULL then second modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the second modifier in the comma delimited list of LN_PROC_MOD |
ThirdModifier
: stringThird modifier associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ThirdModifier |
|
||
CMS ACO Part A Procedure Files Load
| ThirdModifier |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ThirdModifier |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ThirdModifier |
|
||
CMS CJR DME Claim Procedure Load
| ThirdModifier |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| ThirdModifier |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| ThirdModifier |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| ThirdModifier |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| ThirdModifier |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| ThirdModifier |
*Not Applicable |
CMS CJR Surgical Procedure Load
| ThirdModifier |
*Not Applicable |
Data Aggregation ICD Procedure Load
| ThirdModifier |
*Not Applicable |
Data Aggregation Service Line Load
| ThirdModifier |
|
||||
|
If MODIFIERS is not NULL then third modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the third modifier in the comma delimited list of LN_PROC_MOD |
Externally Adjudicated ICD Procedure Load
| ThirdModifier |
*Not Applicable |
Externally Adjudicated Service Line Load
| ThirdModifier |
|
||||
|
If MODIFIERS is not NULL then third modifier in the comma delimited list of MODIFIERS Otherwise the third modifier in the comma delimited list of LN_PROC_MOD |
Payer System ICD Procedure Load
| ThirdModifier |
*Not Applicable |
Payer System Service Line Load
| ThirdModifier |
|
||||
|
If MODIFIERS is not NULL then third modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the third modifier in the comma delimited list of LN_PROC_MOD |
Received Claim ICD Procedure Load
| ThirdModifier |
*Not Applicable |
Received Claim Procedure Load
| ThirdModifier |
|
||||||||||
|
If MODIFIERS is not NULL then third modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the third modifier in the comma delimited list of LN_PROC_MOD |
FourthModifier
: stringFourth modifier associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FourthModifier |
|
||
CMS ACO Part A Procedure Files Load
| FourthModifier |
"*Not Applicable" |
CMS ACO Part B DME File Load
| FourthModifier |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FourthModifier |
|
||
CMS CJR DME Claim Procedure Load
| FourthModifier |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| FourthModifier |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| FourthModifier |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| FourthModifier |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| FourthModifier |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| FourthModifier |
*Not Applicable |
CMS CJR Surgical Procedure Load
| FourthModifier |
*Not Applicable |
Data Aggregation ICD Procedure Load
| FourthModifier |
*Not Applicable |
Data Aggregation Service Line Load
| FourthModifier |
|
||||
|
If MODIFIERS is not NULL then fourth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fourth modifier in the comma delimited list of LN_PROC_MOD |
Externally Adjudicated ICD Procedure Load
| FourthModifier |
*Not Applicable |
Externally Adjudicated Service Line Load
| FourthModifier |
|
||||
|
If MODIFIERS is not NULL then fourth modifier in the comma delimited list of MODIFIERS Otherwise the fourth modifier in the comma delimited list of LN_PROC_MOD |
Payer System ICD Procedure Load
| FourthModifier |
*Not Applicable |
Payer System Service Line Load
| FourthModifier |
|
||||
|
If MODIFIERS is not NULL then fourth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fourth modifier in the comma delimited list of LN_PROC_MOD |
Received Claim ICD Procedure Load
| FourthModifier |
*Not Applicable |
Received Claim Procedure Load
| FourthModifier |
|
||||||||||
|
If MODIFIERS is not NULL then fourth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fourth modifier in the comma delimited list of LN_PROC_MOD |
FifthModifier
: stringFifth modifier associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FifthModifier |
|
||
CMS ACO Part A Procedure Files Load
| FifthModifier |
"*Not Applicable" |
CMS ACO Part B DME File Load
| FifthModifier |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FifthModifier |
|
||
CMS CJR DME Claim Procedure Load
| FifthModifier |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| FifthModifier |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| FifthModifier |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| FifthModifier |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| FifthModifier |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| FifthModifier |
*Not Applicable |
CMS CJR Surgical Procedure Load
| FifthModifier |
*Not Applicable |
Data Aggregation ICD Procedure Load
| FifthModifier |
*Not Applicable |
Data Aggregation Service Line Load
| FifthModifier |
|
||||
|
If MODIFIERS is not NULL then fifth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fifth modifier in the comma delimited list of LN_PROC_MOD |
Externally Adjudicated ICD Procedure Load
| FifthModifier |
*Not Applicable |
Externally Adjudicated Service Line Load
| FifthModifier |
|
||||
|
If MODIFIERS is not NULL then fifth modifier in the comma delimited list of MODIFIERS Otherwise the fifth modifier in the comma delimited list of LN_PROC_MOD |
Payer System ICD Procedure Load
| FifthModifier |
*Not Applicable |
Payer System Service Line Load
| FifthModifier |
|
||||
|
If MODIFIERS is not NULL then fifth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fifth modifier in the comma delimited list of LN_PROC_MOD |
Received Claim ICD Procedure Load
| FifthModifier |
*Not Applicable |
Received Claim Procedure Load
| FifthModifier |
|
||||||||||
|
If MODIFIERS is not NULL then fifth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the fifth modifier in the comma delimited list of LN_PROC_MOD |
SixthModifier
: stringSixth modifier associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SixthModifier |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| SixthModifier |
"*Not Applicable" |
CMS ACO Part B DME File Load
| SixthModifier |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SixthModifier |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| SixthModifier |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| SixthModifier |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| SixthModifier |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| SixthModifier |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| SixthModifier |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| SixthModifier |
*Not Applicable |
CMS CJR Surgical Procedure Load
| SixthModifier |
*Not Applicable |
Data Aggregation ICD Procedure Load
| SixthModifier |
*Not Applicable |
Data Aggregation Service Line Load
| SixthModifier |
|
||||
|
If MODIFIERS is not NULL then sixth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the sixth modifier in the comma delimited list of LN_PROC_MOD |
Externally Adjudicated ICD Procedure Load
| SixthModifier |
*Not Applicable |
Externally Adjudicated Service Line Load
| SixthModifier |
|
||||
|
If MODIFIERS is not NULL then sixth modifier in the comma delimited list of MODIFIERS Otherwise the sixth modifier in the comma delimited list of LN_PROC_MOD |
Payer System ICD Procedure Load
| SixthModifier |
*Not Applicable |
Payer System Service Line Load
| SixthModifier |
|
||||
|
If MODIFIERS is not NULL then sixth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the sixth modifier in the comma delimited list of LN_PROC_MOD |
Received Claim ICD Procedure Load
| SixthModifier |
*Not Applicable |
Received Claim Procedure Load
| SixthModifier |
|
||||||||||
|
If MODIFIERS is not NULL then sixth modifier in the comma delimited list of MODIFIERS Otherwise if the number of services has not been modified in the system then the sixth modifier in the comma delimited list of LN_PROC_MOD |
FirstDiagnosisType
: stringType of the first diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FirstDiagnosisType |
If MsspPartADiagnosisCode.FirstDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FirstDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part A Procedure Files Load
| FirstDiagnosisType |
If MsspPartADiagnosisCode.FirstDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FirstDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part B DME File Load
| FirstDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FirstDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS CJR DME Claim Procedure Load
| FirstDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Home Health Claim Procedure Load
| FirstDiagnosisType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| FirstDiagnosisType |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| FirstDiagnosisType |
|
||||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Part B Claim Procedure Load
| FirstDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD-9 or CLM_THRU_DT < 2015-10-01 then ICD-9-CM Otherwise if ( DGNS_PRCDR_ICD_IND = 0-ICD-10 or DGNS_PRCDR_ICD_IND is NULL ) and CLM_THRU_DT >= 2015-10-01 then ICD-10-CM Otherwise Unspecified |
CMS CJR Skilled Nursing Claim Procedure Load
| FirstDiagnosisType |
*Not Applicable |
CMS CJR Surgical Procedure Load
| FirstDiagnosisType |
*Not Applicable |
Data Aggregation ICD Procedure Load
| FirstDiagnosisType |
*Not Applicable |
Data Aggregation Service Line Load
| FirstDiagnosisType |
|
||||
Externally Adjudicated ICD Procedure Load
| FirstDiagnosisType |
*Not Applicable |
Externally Adjudicated Service Line Load
| FirstDiagnosisType |
|
||||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 1 then NAME |
Payer System ICD Procedure Load
| FirstDiagnosisType |
*Not Applicable |
Payer System Service Line Load
| FirstDiagnosisType |
|
||||
Received Claim ICD Procedure Load
| FirstDiagnosisType |
*Not Applicable |
Received Claim Procedure Load
| FirstDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 1 then NAME |
FirstDiagnosisCode
: stringCode of the first diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FirstDiagnosisCode |
MsspPartADiagnosisCode.FirstDiagnosisCode |
CMS ACO Part A Procedure Files Load
| FirstDiagnosisCode |
MsspPartADiagnosisCode.FirstDiagnosisCode |
CMS ACO Part B DME File Load
| FirstDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FirstDiagnosisCode |
|
||
CMS CJR DME Claim Procedure Load
| FirstDiagnosisCode |
|
||
CMS CJR Home Health Claim Procedure Load
| FirstDiagnosisCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| FirstDiagnosisCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| FirstDiagnosisCode |
|
||
CMS CJR Part B Claim Procedure Load
| FirstDiagnosisCode |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| FirstDiagnosisCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| FirstDiagnosisCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| FirstDiagnosisCode |
*Not Applicable |
Data Aggregation Service Line Load
| FirstDiagnosisCode |
|
||||
Externally Adjudicated ICD Procedure Load
| FirstDiagnosisCode |
*Not Applicable |
Externally Adjudicated Service Line Load
| FirstDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 1 |
Payer System ICD Procedure Load
| FirstDiagnosisCode |
*Not Applicable |
Payer System Service Line Load
| FirstDiagnosisCode |
|
||||
Received Claim ICD Procedure Load
| FirstDiagnosisCode |
*Not Applicable |
Received Claim Procedure Load
| FirstDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 1 |
SecondDiagnosisType
: stringType of the second diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SecondDiagnosisType |
If MsspPartADiagnosisCode.SecondDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If SecondDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part A Procedure Files Load
| SecondDiagnosisType |
If MsspPartADiagnosisCode.SecondDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If SecondDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part B DME File Load
| SecondDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SecondDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS CJR DME Claim Procedure Load
| SecondDiagnosisType |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| SecondDiagnosisType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| SecondDiagnosisType |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| SecondDiagnosisType |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| SecondDiagnosisType |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| SecondDiagnosisType |
*Not Applicable |
CMS CJR Surgical Procedure Load
| SecondDiagnosisType |
*Not Applicable |
Data Aggregation ICD Procedure Load
| SecondDiagnosisType |
*Not Applicable |
Data Aggregation Service Line Load
| SecondDiagnosisType |
|
||||
Externally Adjudicated ICD Procedure Load
| SecondDiagnosisType |
*Not Applicable |
Externally Adjudicated Service Line Load
| SecondDiagnosisType |
|
||||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 2 then NAME |
Payer System ICD Procedure Load
| SecondDiagnosisType |
*Not Applicable |
Payer System Service Line Load
| SecondDiagnosisType |
|
||||
Received Claim ICD Procedure Load
| SecondDiagnosisType |
*Not Applicable |
Received Claim Procedure Load
| SecondDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 2 then NAME |
SecondDiagnosisCode
: stringCode of the second diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SecondDiagnosisCode |
MsspPartADiagnosisCode.SecondDiagnosisCode |
CMS ACO Part A Procedure Files Load
| SecondDiagnosisCode |
MsspPartADiagnosisCode.SecondDiagnosisCode |
CMS ACO Part B DME File Load
| SecondDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SecondDiagnosisCode |
|
||
CMS CJR DME Claim Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
Data Aggregation Service Line Load
| SecondDiagnosisCode |
|
||||
Externally Adjudicated ICD Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
Externally Adjudicated Service Line Load
| SecondDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 2 |
Payer System ICD Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
Payer System Service Line Load
| SecondDiagnosisCode |
|
||||
Received Claim ICD Procedure Load
| SecondDiagnosisCode |
*Not Applicable |
Received Claim Procedure Load
| SecondDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 2 |
ThirdDiagnosisType
: stringType of the third diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ThirdDiagnosisType |
If MsspPartADiagnosisCode.ThirdDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If ThirdDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part A Procedure Files Load
| ThirdDiagnosisType |
If MsspPartADiagnosisCode.ThirdDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If ThirdDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part B DME File Load
| ThirdDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ThirdDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS CJR DME Claim Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
CMS CJR Surgical Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
Data Aggregation ICD Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
Data Aggregation Service Line Load
| ThirdDiagnosisType |
|
||||
Externally Adjudicated ICD Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
Externally Adjudicated Service Line Load
| ThirdDiagnosisType |
|
||||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 3 then NAME |
Payer System ICD Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
Payer System Service Line Load
| ThirdDiagnosisType |
|
||||
Received Claim ICD Procedure Load
| ThirdDiagnosisType |
*Not Applicable |
Received Claim Procedure Load
| ThirdDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 3 then NAME |
ThirdDiagnosisCode
: stringCode of the third diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ThirdDiagnosisCode |
MsspPartADiagnosisCode.ThirdDiagnosisCode |
CMS ACO Part A Procedure Files Load
| ThirdDiagnosisCode |
MsspPartADiagnosisCode.ThirdDiagnosisCode |
CMS ACO Part B DME File Load
| ThirdDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ThirdDiagnosisCode |
|
||
CMS CJR DME Claim Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
Data Aggregation Service Line Load
| ThirdDiagnosisCode |
|
||||
Externally Adjudicated ICD Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
Externally Adjudicated Service Line Load
| ThirdDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 3 |
Payer System ICD Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
Payer System Service Line Load
| ThirdDiagnosisCode |
|
||||
Received Claim ICD Procedure Load
| ThirdDiagnosisCode |
*Not Applicable |
Received Claim Procedure Load
| ThirdDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 3 |
FourthDiagnosisType
: stringType of the fourth diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FourthDiagnosisType |
If MsspPartADiagnosisCode.FourthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FourthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part A Procedure Files Load
| FourthDiagnosisType |
If MsspPartADiagnosisCode.FourthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FourthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part B DME File Load
| FourthDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FourthDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS CJR DME Claim Procedure Load
| FourthDiagnosisType |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| FourthDiagnosisType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| FourthDiagnosisType |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| FourthDiagnosisType |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| FourthDiagnosisType |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| FourthDiagnosisType |
*Not Applicable |
CMS CJR Surgical Procedure Load
| FourthDiagnosisType |
*Not Applicable |
Data Aggregation ICD Procedure Load
| FourthDiagnosisType |
*Not Applicable |
Data Aggregation Service Line Load
| FourthDiagnosisType |
|
||||
Externally Adjudicated ICD Procedure Load
| FourthDiagnosisType |
*Not Applicable |
Externally Adjudicated Service Line Load
| FourthDiagnosisType |
|
||||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then NAME |
Payer System ICD Procedure Load
| FourthDiagnosisType |
*Not Applicable |
Payer System Service Line Load
| FourthDiagnosisType |
|
||||
Received Claim ICD Procedure Load
| FourthDiagnosisType |
*Not Applicable |
Received Claim Procedure Load
| FourthDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then NAME |
FourthDiagnosisCode
: stringCode of the fourth diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FourthDiagnosisCode |
MsspPartADiagnosisCode.FourthDiagnosisCode |
CMS ACO Part A Procedure Files Load
| FourthDiagnosisCode |
MsspPartADiagnosisCode.FourthDiagnosisCode |
CMS ACO Part B DME File Load
| FourthDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FourthDiagnosisCode |
|
||
CMS CJR DME Claim Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
Data Aggregation Service Line Load
| FourthDiagnosisCode |
|
||||
Externally Adjudicated ICD Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
Externally Adjudicated Service Line Load
| FourthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 4 |
Payer System ICD Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
Payer System Service Line Load
| FourthDiagnosisCode |
|
||||
Received Claim ICD Procedure Load
| FourthDiagnosisCode |
*Not Applicable |
Received Claim Procedure Load
| FourthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 4 |
FifthDiagnosisType
: stringType of the fifth diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FifthDiagnosisType |
If MsspPartADiagnosisCode.FifthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FifthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part A Procedure Files Load
| FifthDiagnosisType |
If MsspPartADiagnosisCode.FifthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If FifthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part B DME File Load
| FifthDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FifthDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS CJR DME Claim Procedure Load
| FifthDiagnosisType |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| FifthDiagnosisType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| FifthDiagnosisType |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| FifthDiagnosisType |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| FifthDiagnosisType |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| FifthDiagnosisType |
*Not Applicable |
CMS CJR Surgical Procedure Load
| FifthDiagnosisType |
*Not Applicable |
Data Aggregation ICD Procedure Load
| FifthDiagnosisType |
*Not Applicable |
Data Aggregation Service Line Load
| FifthDiagnosisType |
|
||||
Externally Adjudicated ICD Procedure Load
| FifthDiagnosisType |
*Not Applicable |
Externally Adjudicated Service Line Load
| FifthDiagnosisType |
|
||||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 5 then NAME |
Payer System ICD Procedure Load
| FifthDiagnosisType |
*Not Applicable |
Payer System Service Line Load
| FifthDiagnosisType |
|
||||
Received Claim ICD Procedure Load
| FifthDiagnosisType |
*Not Applicable |
Received Claim Procedure Load
| FifthDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 5 then NAME |
FifthDiagnosisCode
: stringCode of the fifth diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| FifthDiagnosisCode |
MsspPartADiagnosisCode.FifthDiagnosisCode |
CMS ACO Part A Procedure Files Load
| FifthDiagnosisCode |
MsspPartADiagnosisCode.FifthDiagnosisCode |
CMS ACO Part B DME File Load
| FifthDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| FifthDiagnosisCode |
|
||
CMS CJR DME Claim Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
Data Aggregation Service Line Load
| FifthDiagnosisCode |
|
||||
Externally Adjudicated ICD Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
Externally Adjudicated Service Line Load
| FifthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 5 |
Payer System ICD Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
Payer System Service Line Load
| FifthDiagnosisCode |
|
||||
Received Claim ICD Procedure Load
| FifthDiagnosisCode |
*Not Applicable |
Received Claim Procedure Load
| FifthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 5 |
SixthDiagnosisType
: stringType of the sixth diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SixthDiagnosisType |
If MsspPartADiagnosisCode.SixthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If SixthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part A Procedure Files Load
| SixthDiagnosisType |
If MsspPartADiagnosisCode.SixthDiagnosisFlag = 9 or the MsspPartADiagnosisCode.FileGenerationDate is before 11/01/2015, then "ICD-9-CM". If SixthDiagnosisFlag = 0 and FileGenerationDate is after 11/01/2015, then "ICD-10-CM". Otherwise, "Unknown Code Type" |
CMS ACO Part B DME File Load
| SixthDiagnosisType |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SixthDiagnosisType |
|
||||
|
If DGNS_PRCDR_ICD_IND = 9-ICD 9 or FileGenerationDate < 2015-11-1 then "ICD-9-CM" Otherwise if DGNS_PRCDR_ICD_IND = 0-ICD 10 and FileGenerationDate >= 2015-11-1 then "ICD-10-CM" Otherwise "Unknown Code Type" |
CMS CJR DME Claim Procedure Load
| SixthDiagnosisType |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| SixthDiagnosisType |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| SixthDiagnosisType |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| SixthDiagnosisType |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| SixthDiagnosisType |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| SixthDiagnosisType |
*Not Applicable |
CMS CJR Surgical Procedure Load
| SixthDiagnosisType |
*Not Applicable |
Data Aggregation ICD Procedure Load
| SixthDiagnosisType |
*Not Applicable |
Data Aggregation Service Line Load
| SixthDiagnosisType |
|
||||
Externally Adjudicated ICD Procedure Load
| SixthDiagnosisType |
*Not Applicable |
Externally Adjudicated Service Line Load
| SixthDiagnosisType |
|
||||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then NAME |
Payer System ICD Procedure Load
| SixthDiagnosisType |
*Not Applicable |
Payer System Service Line Load
| SixthDiagnosisType |
|
||||
Received Claim ICD Procedure Load
| SixthDiagnosisType |
*Not Applicable |
Received Claim Procedure Load
| SixthDiagnosisType |
|
||||||
|
If REF_BILL_CODE_SET_C = 1 or 2 where LINE = 4 then NAME |
SixthDiagnosisCode
: stringCode of the sixth diagnosis associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| SixthDiagnosisCode |
MsspPartADiagnosisCode.SixthDiagnosisCode |
CMS ACO Part A Procedure Files Load
| SixthDiagnosisCode |
MsspPartADiagnosisCode.SixthDiagnosisCode |
CMS ACO Part B DME File Load
| SixthDiagnosisCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| SixthDiagnosisCode |
|
||
CMS CJR DME Claim Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
Data Aggregation Service Line Load
| SixthDiagnosisCode |
|
||||
Externally Adjudicated ICD Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
Externally Adjudicated Service Line Load
| SixthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 6 |
Payer System ICD Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
Payer System Service Line Load
| SixthDiagnosisCode |
|
||||
Received Claim ICD Procedure Load
| SixthDiagnosisCode |
*Not Applicable |
Received Claim Procedure Load
| SixthDiagnosisCode |
|
||||||
|
REF_BILL_CODE for DX_ID where AP_PROC_ASSOC_DX.LINE = 6 |
BillingProviderSpecialty
: stringBilling provider specialty associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| BillingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| BillingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| BillingProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| BillingProviderSpecialty |
*Not Applicable |
CMS CJR Surgical Procedure Load
| BillingProviderSpecialty |
*Not Applicable |
Data Aggregation Service Line Load
| BillingProviderSpecialty |
|
||
Externally Adjudicated ICD Procedure Load
| BillingProviderSpecialty |
*Not Applicable |
Externally Adjudicated Service Line Load
| BillingProviderSpecialty |
"*Unspecified" |
Payer System Service Line Load
| BillingProviderSpecialty |
|
||
Received Claim ICD Procedure Load
| BillingProviderSpecialty |
|
||||||||||
Received Claim Procedure Load
| BillingProviderSpecialty |
|
||||||||||
ReferringProviderSpecialty
: stringReferring provider specialty associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderSpecialty |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| ReferringProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ReferringProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| ReferringProviderSpecialty |
*Not Applicable |
CMS CJR Surgical Procedure Load
| ReferringProviderSpecialty |
*Not Applicable |
Externally Adjudicated ICD Procedure Load
| ReferringProviderSpecialty |
*Not Applicable |
Externally Adjudicated Service Line Load
| ReferringProviderSpecialty |
"*Unspecified" |
Received Claim ICD Procedure Load
| ReferringProviderSpecialty |
|
||||||||
|
If REF_PROV_TAXONOMY is not NULL then REF_PROV_TAXONOMY Otherwise if CLARITY_SER_SPEC.SPECIALTY_C is NULL then *Unspecified Otherwise if ZC_SPECIALTY.SPECIALTY_C is NULL then *Unknown Otherwise NAME |
Received Claim Procedure Load
| ReferringProviderSpecialty |
|
||||||||||||||||||
|
If LN_REF_NPI = REF_PROV_NPI and the number of services has not been modified in the system then REF_PROV_TAXONOMY Otherwise if LN_REF_NPI is NULL and the number of services has not been modified in the system then REF_PROV_TAXONOMY Otherwise if CLARITY_SER_SPEC.SPECIALTY_C is NULL then "*Unspecified" Otherwise if ZC_SPECIALTY.SPECIALTY_C is NULL then "*Unknown" Otherwise NAME |
RenderingProviderSpecialty
: stringRendering provider specialty associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| RenderingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RenderingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderSpecialty |
|
||||||||
|
If CLM_PRVDR_SPCLTY_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ProviderSpecialtyCode" then "*Unknown" Otherwise Name where CategoryName = "ProviderSpecialtyCode" |
CMS CJR DME Claim Procedure Load
| RenderingProviderSpecialty |
|
||||||||
|
If HCFASPCL is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ProviderSpecialtyCode then *Unknown Otherwise Name where CategoryName = ProviderSpecialtyCode |
CMS CJR Home Health Claim Procedure Load
| RenderingProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| RenderingProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| RenderingProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| RenderingProviderSpecialty |
|
||||||||
|
If HCFASPCL is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ProviderSpecialtyCode then *Unknown Otherwise Name where CategoryName = ProviderSpecialtyCode |
CMS CJR Skilled Nursing Claim Procedure Load
| RenderingProviderSpecialty |
*Not Applicable |
CMS CJR Surgical Procedure Load
| RenderingProviderSpecialty |
*Not Applicable |
Externally Adjudicated ICD Procedure Load
| RenderingProviderSpecialty |
*Not Applicable |
Externally Adjudicated Service Line Load
| RenderingProviderSpecialty |
"*Unspecified" |
Received Claim ICD Procedure Load
| RenderingProviderSpecialty |
|
||||||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY |
Received Claim Procedure Load
| RenderingProviderSpecialty |
|
||||||||||||||||||||||||||||
|
If the number of services has been modified in the system then NULL Otherwise if LN_REND_NPI is not NULL then LN_REND_TAXONOMY Otherwise if REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY |
AttendingProviderSpecialty
: stringAttending provider specialty associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| AttendingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| AttendingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AttendingProviderSpecialty |
*Not Applicable |
CMS CJR Surgical Procedure Load
| AttendingProviderSpecialty |
*Not Applicable |
Externally Adjudicated ICD Procedure Load
| AttendingProviderSpecialty |
*Not Applicable |
Externally Adjudicated Service Line Load
| AttendingProviderSpecialty |
"*Unspecified" |
Received Claim ICD Procedure Load
| AttendingProviderSpecialty |
|
||
Received Claim Procedure Load
| AttendingProviderSpecialty |
|
||
OperatingProviderSpecialty
: stringOperating provider specialty associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OperatingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OperatingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
Data Aggregation Service Line Load
| OperatingProviderSpecialty |
"*Unspecified" |
Externally Adjudicated ICD Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
Externally Adjudicated Service Line Load
| OperatingProviderSpecialty |
"*Unspecified" |
Payer System ICD Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
Payer System Service Line Load
| OperatingProviderSpecialty |
"*Unspecified" |
Received Claim ICD Procedure Load
| OperatingProviderSpecialty |
*Not Applicable |
Received Claim Procedure Load
| OperatingProviderSpecialty |
"*Unspecified" |
OtherProviderSpecialty
: stringSpecialty of the other provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderSpecialty |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OtherProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OtherProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OtherProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
Data Aggregation Service Line Load
| OtherProviderSpecialty |
"*Unspecified" |
Externally Adjudicated ICD Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
Externally Adjudicated Service Line Load
| OtherProviderSpecialty |
"*Unspecified" |
Payer System ICD Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
Payer System Service Line Load
| OtherProviderSpecialty |
"*Unspecified" |
Received Claim ICD Procedure Load
| OtherProviderSpecialty |
*Not Applicable |
Received Claim Procedure Load
| OtherProviderSpecialty |
"*Unspecified" |
OrderingProviderSpecialty
: stringOrdering provider specialty associated with the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OrderingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OrderingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OrderingProviderSpecialty |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OrderingProviderSpecialty |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
Data Aggregation Service Line Load
| OrderingProviderSpecialty |
"*Unspecified" |
Externally Adjudicated ICD Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
Externally Adjudicated Service Line Load
| OrderingProviderSpecialty |
"*Unspecified" |
Payer System ICD Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
Payer System Service Line Load
| OrderingProviderSpecialty |
"*Unspecified" |
Received Claim ICD Procedure Load
| OrderingProviderSpecialty |
*Not Applicable |
Received Claim Procedure Load
| OrderingProviderSpecialty |
"*Unspecified" |
BillingProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider under whose license number the claim was sent
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| BillingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| BillingProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| BillingProviderCmsSpecialtyCode |
NULL |
Data Aggregation Service Line Load
| BillingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated ICD Procedure Load
| BillingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Service Line Load
| BillingProviderCmsSpecialtyCode |
NULL |
Payer System ICD Procedure Load
| BillingProviderCmsSpecialtyCode |
NULL |
Payer System Service Line Load
| BillingProviderCmsSpecialtyCode |
NULL |
Received Claim ICD Procedure Load
| BillingProviderCmsSpecialtyCode |
NULL |
Received Claim Procedure Load
| BillingProviderCmsSpecialtyCode |
NULL |
BillingProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider under whose license number the claim was sent
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| BillingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| BillingProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| BillingProviderCmsSpecialtyName |
NULL |
Data Aggregation Service Line Load
| BillingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated ICD Procedure Load
| BillingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Service Line Load
| BillingProviderCmsSpecialtyName |
NULL |
Payer System ICD Procedure Load
| BillingProviderCmsSpecialtyName |
NULL |
Payer System Service Line Load
| BillingProviderCmsSpecialtyName |
NULL |
Received Claim ICD Procedure Load
| BillingProviderCmsSpecialtyName |
NULL |
Received Claim Procedure Load
| BillingProviderCmsSpecialtyName |
NULL |
ReferringProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider who referred the patient to another provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| ReferringProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Data Aggregation Service Line Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated ICD Procedure Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Service Line Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Payer System ICD Procedure Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Payer System Service Line Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Received Claim ICD Procedure Load
| ReferringProviderCmsSpecialtyCode |
NULL |
Received Claim Procedure Load
| ReferringProviderCmsSpecialtyCode |
NULL |
ReferringProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider who referred the patient to another provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| ReferringProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| ReferringProviderCmsSpecialtyName |
NULL |
Data Aggregation Service Line Load
| ReferringProviderCmsSpecialtyName |
NULL |
Externally Adjudicated ICD Procedure Load
| ReferringProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Service Line Load
| ReferringProviderCmsSpecialtyName |
NULL |
Payer System ICD Procedure Load
| ReferringProviderCmsSpecialtyName |
NULL |
Payer System Service Line Load
| ReferringProviderCmsSpecialtyName |
NULL |
Received Claim ICD Procedure Load
| ReferringProviderCmsSpecialtyName |
NULL |
Received Claim Procedure Load
| ReferringProviderCmsSpecialtyName |
NULL |
RenderingProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider who rendered the care
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RenderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderCmsSpecialtyCode |
|
||
CMS CJR DME Claim Procedure Load
| RenderingProviderCmsSpecialtyCode |
|
||
CMS CJR Home Health Claim Procedure Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| RenderingProviderCmsSpecialtyCode |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| RenderingProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Data Aggregation Service Line Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated ICD Procedure Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Service Line Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Payer System ICD Procedure Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Payer System Service Line Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Received Claim ICD Procedure Load
| RenderingProviderCmsSpecialtyCode |
NULL |
Received Claim Procedure Load
| RenderingProviderCmsSpecialtyCode |
NULL |
RenderingProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider who rendered the care
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RenderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderCmsSpecialtyName |
|
||||||||
|
If CLM_PRVDR_SPCLTY_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ProviderSpecialtyCode" then "*Unknown " Otherwise Name where CategoryName = "ProviderSpecialtyCode" |
CMS CJR DME Claim Procedure Load
| RenderingProviderCmsSpecialtyName |
|
||||||||
|
If HCFASPCL is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ProviderSpecialtyCode then *Unknown Otherwise Name where CategoryName = ProviderSpecialtyCode |
CMS CJR Home Health Claim Procedure Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| RenderingProviderCmsSpecialtyName |
|
||||||||
|
If HCFASPCL is NULL then *Unspecified Otherwise if Id is NULL where CategoryName = ProviderSpecialtyCode then *Unknown Otherwise Name where CategoryName = ProviderSpecialtyCode |
CMS CJR Skilled Nursing Claim Procedure Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| RenderingProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| RenderingProviderCmsSpecialtyName |
NULL |
Data Aggregation Service Line Load
| RenderingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated ICD Procedure Load
| RenderingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Service Line Load
| RenderingProviderCmsSpecialtyName |
NULL |
Payer System ICD Procedure Load
| RenderingProviderCmsSpecialtyName |
NULL |
Payer System Service Line Load
| RenderingProviderCmsSpecialtyName |
NULL |
Received Claim ICD Procedure Load
| RenderingProviderCmsSpecialtyName |
NULL |
Received Claim Procedure Load
| RenderingProviderCmsSpecialtyName |
NULL |
AttendingProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider who managed the overall care of the admitted patient
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| AttendingProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Data Aggregation Service Line Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated ICD Procedure Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Service Line Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Payer System ICD Procedure Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Payer System Service Line Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Received Claim ICD Procedure Load
| AttendingProviderCmsSpecialtyCode |
NULL |
Received Claim Procedure Load
| AttendingProviderCmsSpecialtyCode |
NULL |
AttendingProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider who managed the overall care of the admitted patient
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| AttendingProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| AttendingProviderCmsSpecialtyName |
NULL |
Data Aggregation Service Line Load
| AttendingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated ICD Procedure Load
| AttendingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Service Line Load
| AttendingProviderCmsSpecialtyName |
NULL |
Payer System ICD Procedure Load
| AttendingProviderCmsSpecialtyName |
NULL |
Payer System Service Line Load
| AttendingProviderCmsSpecialtyName |
NULL |
Received Claim ICD Procedure Load
| AttendingProviderCmsSpecialtyName |
NULL |
Received Claim Procedure Load
| AttendingProviderCmsSpecialtyName |
NULL |
OperatingProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OperatingProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Data Aggregation Service Line Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated ICD Procedure Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Service Line Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Payer System ICD Procedure Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Payer System Service Line Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Received Claim ICD Procedure Load
| OperatingProviderCmsSpecialtyCode |
NULL |
Received Claim Procedure Load
| OperatingProviderCmsSpecialtyCode |
NULL |
OperatingProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OperatingProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OperatingProviderCmsSpecialtyName |
NULL |
Data Aggregation Service Line Load
| OperatingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated ICD Procedure Load
| OperatingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Service Line Load
| OperatingProviderCmsSpecialtyName |
NULL |
Payer System ICD Procedure Load
| OperatingProviderCmsSpecialtyName |
NULL |
Payer System Service Line Load
| OperatingProviderCmsSpecialtyName |
NULL |
Received Claim ICD Procedure Load
| OperatingProviderCmsSpecialtyName |
NULL |
Received Claim Procedure Load
| OperatingProviderCmsSpecialtyName |
NULL |
OtherProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the other provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OtherProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OtherProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OtherProviderCmsSpecialtyCode |
NULL |
Data Aggregation Service Line Load
| OtherProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated ICD Procedure Load
| OtherProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Service Line Load
| OtherProviderCmsSpecialtyCode |
NULL |
Payer System ICD Procedure Load
| OtherProviderCmsSpecialtyCode |
NULL |
Payer System Service Line Load
| OtherProviderCmsSpecialtyCode |
NULL |
Received Claim ICD Procedure Load
| OtherProviderCmsSpecialtyCode |
NULL |
Received Claim Procedure Load
| OtherProviderCmsSpecialtyCode |
NULL |
OtherProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the other provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OtherProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OtherProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OtherProviderCmsSpecialtyName |
NULL |
Data Aggregation Service Line Load
| OtherProviderCmsSpecialtyName |
NULL |
Externally Adjudicated ICD Procedure Load
| OtherProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Service Line Load
| OtherProviderCmsSpecialtyName |
NULL |
Payer System ICD Procedure Load
| OtherProviderCmsSpecialtyName |
NULL |
Payer System Service Line Load
| OtherProviderCmsSpecialtyName |
NULL |
Received Claim ICD Procedure Load
| OtherProviderCmsSpecialtyName |
NULL |
Received Claim Procedure Load
| OtherProviderCmsSpecialtyName |
NULL |
OrderingProviderCmsSpecialtyCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the specialty of the provider who ordered the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OrderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OrderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OrderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OrderingProviderCmsSpecialtyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OrderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OrderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OrderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OrderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OrderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OrderingProviderCmsSpecialtyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OrderingProviderCmsSpecialtyCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OrderingProviderCmsSpecialtyCode |
NULL |
Data Aggregation Service Line Load
| OrderingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated ICD Procedure Load
| OrderingProviderCmsSpecialtyCode |
NULL |
Externally Adjudicated Service Line Load
| OrderingProviderCmsSpecialtyCode |
NULL |
Payer System ICD Procedure Load
| OrderingProviderCmsSpecialtyCode |
NULL |
Payer System Service Line Load
| OrderingProviderCmsSpecialtyCode |
NULL |
Received Claim ICD Procedure Load
| OrderingProviderCmsSpecialtyCode |
NULL |
Received Claim Procedure Load
| OrderingProviderCmsSpecialtyCode |
NULL |
OrderingProviderCmsSpecialtyName
: stringCenters for Medicare & Medicaid Services (CMS) name for the specialty of the provider who ordered the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OrderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OrderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OrderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OrderingProviderCmsSpecialtyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OrderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OrderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OrderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OrderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OrderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OrderingProviderCmsSpecialtyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OrderingProviderCmsSpecialtyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OrderingProviderCmsSpecialtyName |
NULL |
Data Aggregation Service Line Load
| OrderingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated ICD Procedure Load
| OrderingProviderCmsSpecialtyName |
NULL |
Externally Adjudicated Service Line Load
| OrderingProviderCmsSpecialtyName |
NULL |
Payer System ICD Procedure Load
| OrderingProviderCmsSpecialtyName |
NULL |
Payer System Service Line Load
| OrderingProviderCmsSpecialtyName |
NULL |
Received Claim ICD Procedure Load
| OrderingProviderCmsSpecialtyName |
NULL |
Received Claim Procedure Load
| OrderingProviderCmsSpecialtyName |
NULL |
BillingProviderTaxonomyCode
: stringThe NUCC taxonomy code for the provider under whose license number the claim was sent
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| BillingProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| BillingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| BillingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Service Line Load
| BillingProviderTaxonomyCode |
|
||||
Externally Adjudicated ICD Procedure Load
| BillingProviderTaxonomyCode |
NULL |
Externally Adjudicated Service Line Load
| BillingProviderTaxonomyCode |
NULL |
Payer System Service Line Load
| BillingProviderTaxonomyCode |
|
||||
Received Claim ICD Procedure Load
| BillingProviderTaxonomyCode |
|
||||
Received Claim Procedure Load
| BillingProviderTaxonomyCode |
|
||||
BillingProviderTaxonomyName
: stringName of the NUCC taxonomy code for the provider under whose license number the claim was sent
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| BillingProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| BillingProviderTaxonomyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| BillingProviderTaxonomyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| BillingProviderTaxonomyName |
NULL |
Data Aggregation Service Line Load
| BillingProviderTaxonomyName |
NULL |
Externally Adjudicated ICD Procedure Load
| BillingProviderTaxonomyName |
NULL |
Externally Adjudicated Service Line Load
| BillingProviderTaxonomyName |
NULL |
Payer System ICD Procedure Load
| BillingProviderTaxonomyName |
NULL |
Payer System Service Line Load
| BillingProviderTaxonomyName |
NULL |
Received Claim ICD Procedure Load
| BillingProviderTaxonomyName |
NULL |
Received Claim Procedure Load
| BillingProviderTaxonomyName |
NULL |
ReferringProviderTaxonomyCode
: stringThe NUCC taxonomy code for the provider who referred the patient to another provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| ReferringProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Service Line Load
| ReferringProviderTaxonomyCode |
|
||
Externally Adjudicated ICD Procedure Load
| ReferringProviderTaxonomyCode |
NULL |
Externally Adjudicated Service Line Load
| ReferringProviderTaxonomyCode |
NULL |
Payer System Service Line Load
| ReferringProviderTaxonomyCode |
|
||
Received Claim ICD Procedure Load
| ReferringProviderTaxonomyCode |
|
||
Received Claim Procedure Load
| ReferringProviderTaxonomyCode |
|
||||||||||||
|
If LN_REF_NPI = REF_PROV_NPI and the number of services has not been modified in the system then REF_PROV_TAXONOMY Otherwise if LN_REF_NPI is NULL and the number of services has not been modified in the system then REF_PROV_TAXONOMY Otherwise "*Unspecified" |
ReferringProviderTaxonomyName
: stringName of the NUCC taxonomy code for the provider who referred the patient to another provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| ReferringProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| ReferringProviderTaxonomyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| ReferringProviderTaxonomyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| ReferringProviderTaxonomyName |
NULL |
Data Aggregation Service Line Load
| ReferringProviderTaxonomyName |
NULL |
Externally Adjudicated ICD Procedure Load
| ReferringProviderTaxonomyName |
NULL |
Externally Adjudicated Service Line Load
| ReferringProviderTaxonomyName |
NULL |
Payer System ICD Procedure Load
| ReferringProviderTaxonomyName |
NULL |
Payer System Service Line Load
| ReferringProviderTaxonomyName |
NULL |
Received Claim ICD Procedure Load
| ReferringProviderTaxonomyName |
NULL |
Received Claim Procedure Load
| ReferringProviderTaxonomyName |
NULL |
RenderingProviderTaxonomyCode
: stringThe NUCC taxonomy code for the provider who rendered the care
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| RenderingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Service Line Load
| RenderingProviderTaxonomyCode |
|
||
Externally Adjudicated ICD Procedure Load
| RenderingProviderTaxonomyCode |
NULL |
Externally Adjudicated Service Line Load
| RenderingProviderTaxonomyCode |
NULL |
Payer System Service Line Load
| RenderingProviderTaxonomyCode |
|
||
Received Claim ICD Procedure Load
| RenderingProviderTaxonomyCode |
|
||||||||||||||||||
|
If REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY |
Received Claim Procedure Load
| RenderingProviderTaxonomyCode |
|
||||||||||||||||||||||||||||
|
If the number of services has been modified in the system then NULL Otherwise if LN_REND_NPI is not NULL then LN_REND_TAXONOMY Otherwise if REND_PROV_NPI is not NULL then REND_PROV_TAXONOMY Otherwise if RENDERING_PROV_ID is not NULL then NULL Otherwise if CLAIM_FORMAT = 1 and DENTAL_INFO_YN = "Y" and ASST_SURG_NPI is not NULL then ASST_SURG_TAXONOMY Otherwise if CLAIM_FORMAT = 1 and BIL_PROV_NPI is not NULL then BIL_PROV_TAXONOMY |
RenderingProviderTaxonomyName
: stringName of the NUCC taxonomy code for the provider who rendered the care
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| RenderingProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| RenderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| RenderingProviderTaxonomyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| RenderingProviderTaxonomyName |
NULL |
Data Aggregation Service Line Load
| RenderingProviderTaxonomyName |
NULL |
Externally Adjudicated ICD Procedure Load
| RenderingProviderTaxonomyName |
NULL |
Externally Adjudicated Service Line Load
| RenderingProviderTaxonomyName |
NULL |
Payer System ICD Procedure Load
| RenderingProviderTaxonomyName |
NULL |
Payer System Service Line Load
| RenderingProviderTaxonomyName |
NULL |
Received Claim ICD Procedure Load
| RenderingProviderTaxonomyName |
NULL |
Received Claim Procedure Load
| RenderingProviderTaxonomyName |
NULL |
AttendingProviderTaxonomyCode
: stringThe NUCC taxonomy code for the provider who managed the overall care of the admitted patient
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| AttendingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Service Line Load
| AttendingProviderTaxonomyCode |
|
||
Externally Adjudicated ICD Procedure Load
| AttendingProviderTaxonomyCode |
NULL |
Externally Adjudicated Service Line Load
| AttendingProviderTaxonomyCode |
|
||
Payer System Service Line Load
| AttendingProviderTaxonomyCode |
|
||
Received Claim ICD Procedure Load
| AttendingProviderTaxonomyCode |
|
||
Received Claim Procedure Load
| AttendingProviderTaxonomyCode |
|
||
AttendingProviderTaxonomyName
: stringName of the NUCC taxonomy code for the provider who managed the overall care of the admitted patient
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| AttendingProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| AttendingProviderTaxonomyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| AttendingProviderTaxonomyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| AttendingProviderTaxonomyName |
NULL |
Data Aggregation Service Line Load
| AttendingProviderTaxonomyName |
NULL |
Externally Adjudicated ICD Procedure Load
| AttendingProviderTaxonomyName |
NULL |
Externally Adjudicated Service Line Load
| AttendingProviderTaxonomyName |
NULL |
Payer System ICD Procedure Load
| AttendingProviderTaxonomyName |
NULL |
Payer System Service Line Load
| AttendingProviderTaxonomyName |
NULL |
Received Claim ICD Procedure Load
| AttendingProviderTaxonomyName |
NULL |
Received Claim Procedure Load
| AttendingProviderTaxonomyName |
NULL |
OperatingProviderTaxonomyCode
: stringTaxonomy code for the provider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Service Line Load
| OperatingProviderTaxonomyCode |
|
||||||
|
If LN_OPER_TAXONOMY is not null then LN_OPER_TAXONOMY Otherwise OPER_PROV_TAXONOMY |
Externally Adjudicated ICD Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
Externally Adjudicated Service Line Load
| OperatingProviderTaxonomyCode |
"*Unspecified" |
Payer System ICD Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
Payer System Service Line Load
| OperatingProviderTaxonomyCode |
|
||||||
|
If LN_OPER_TAXONOMY is not null then LN_OPER_TAXONOMY Otherwise OPER_PROV_TAXONOMY |
Received Claim ICD Procedure Load
| OperatingProviderTaxonomyCode |
*Not Applicable |
Received Claim Procedure Load
| OperatingProviderTaxonomyCode |
"*Unspecified" |
OperatingProviderTaxonomyName
: stringName of the taxonomy code for the provider who had the primary responsibility for performing the surgical procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OperatingProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OperatingProviderTaxonomyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OperatingProviderTaxonomyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OperatingProviderTaxonomyName |
NULL |
Data Aggregation Service Line Load
| OperatingProviderTaxonomyName |
NULL |
Externally Adjudicated ICD Procedure Load
| OperatingProviderTaxonomyName |
NULL |
Externally Adjudicated Service Line Load
| OperatingProviderTaxonomyName |
NULL |
Payer System ICD Procedure Load
| OperatingProviderTaxonomyName |
NULL |
Payer System Service Line Load
| OperatingProviderTaxonomyName |
NULL |
Received Claim ICD Procedure Load
| OperatingProviderTaxonomyName |
NULL |
Received Claim Procedure Load
| OperatingProviderTaxonomyName |
NULL |
OtherProviderTaxonomyCode
: stringTaxonomy code for the other provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OtherProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Service Line Load
| OtherProviderTaxonomyCode |
"*Unspecified" |
Externally Adjudicated ICD Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
Externally Adjudicated Service Line Load
| OtherProviderTaxonomyCode |
"*Unspecified" |
Payer System ICD Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
Payer System Service Line Load
| OtherProviderTaxonomyCode |
"*Unspecified" |
Received Claim ICD Procedure Load
| OtherProviderTaxonomyCode |
*Not Applicable |
Received Claim Procedure Load
| OtherProviderTaxonomyCode |
"*Unspecified" |
OtherProviderTaxonomyName
: stringName of the taxonomy code for the other provider
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OtherProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OtherProviderTaxonomyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OtherProviderTaxonomyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OtherProviderTaxonomyName |
NULL |
Data Aggregation Service Line Load
| OtherProviderTaxonomyName |
NULL |
Externally Adjudicated ICD Procedure Load
| OtherProviderTaxonomyName |
NULL |
Externally Adjudicated Service Line Load
| OtherProviderTaxonomyName |
NULL |
Payer System ICD Procedure Load
| OtherProviderTaxonomyName |
NULL |
Payer System Service Line Load
| OtherProviderTaxonomyName |
NULL |
Received Claim ICD Procedure Load
| OtherProviderTaxonomyName |
NULL |
Received Claim Procedure Load
| OtherProviderTaxonomyName |
NULL |
OrderingProviderTaxonomyCode
: stringTaxonomy code for the provider who ordered the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OrderingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OrderingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OrderingProviderTaxonomyCode |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OrderingProviderTaxonomyCode |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
Data Aggregation Service Line Load
| OrderingProviderTaxonomyCode |
|
||
Externally Adjudicated ICD Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
Externally Adjudicated Service Line Load
| OrderingProviderTaxonomyCode |
"*Unspecified" |
Payer System ICD Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
Payer System Service Line Load
| OrderingProviderTaxonomyCode |
|
||
Received Claim ICD Procedure Load
| OrderingProviderTaxonomyCode |
*Not Applicable |
Received Claim Procedure Load
| OrderingProviderTaxonomyCode |
"*Unspecified" |
OrderingProviderTaxonomyName
: stringName of the taxonomy code for the provider who ordered the procedure
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| OrderingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| OrderingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B DME File Load
| OrderingProviderTaxonomyName |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| OrderingProviderTaxonomyName |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| OrderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Home Health Claim Procedure Load
| OrderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Inpatient Claim Procedure Load
| OrderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Outpatient Claim Procedure Load
| OrderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Part B Claim Procedure Load
| OrderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Skilled Nursing Claim Procedure Load
| OrderingProviderTaxonomyName |
*Not Applicable |
CMS CJR Surgical Procedure Load
| OrderingProviderTaxonomyName |
*Not Applicable |
Data Aggregation ICD Procedure Load
| OrderingProviderTaxonomyName |
NULL |
Data Aggregation Service Line Load
| OrderingProviderTaxonomyName |
NULL |
Externally Adjudicated ICD Procedure Load
| OrderingProviderTaxonomyName |
NULL |
Externally Adjudicated Service Line Load
| OrderingProviderTaxonomyName |
NULL |
Payer System ICD Procedure Load
| OrderingProviderTaxonomyName |
NULL |
Payer System Service Line Load
| OrderingProviderTaxonomyName |
NULL |
Received Claim ICD Procedure Load
| OrderingProviderTaxonomyName |
NULL |
Received Claim Procedure Load
| OrderingProviderTaxonomyName |
NULL |
Workflow
: stringWorkflow associated with the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| Workflow |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| Workflow |
"*Not Applicable" |
CMS ACO Part B DME File Load
| Workflow |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| Workflow |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| Workflow |
CMS CJR Home Health Claim Procedure Load
| Workflow |
CMS CJR Inpatient Claim Procedure Load
| Workflow |
CMS CJR Outpatient Claim Procedure Load
| Workflow |
CMS CJR Part B Claim Procedure Load
| Workflow |
CMS CJR Skilled Nursing Claim Procedure Load
| Workflow |
CMS CJR Surgical Procedure Load
| Workflow |
Data Aggregation ICD Procedure Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Data Aggregation Service Line Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Externally Adjudicated ICD Procedure Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Externally Adjudicated Service Line Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Payer System ICD Procedure Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Payer System Service Line Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Received Claim ICD Procedure Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
Received Claim Procedure Load
| Workflow |
|
||||||
|
If ZC_WORKFLOW.WORKFLOW_C is NULL then "*Unknown" Otherwise ZC_WORKFLOW.NAME |
LineProcessingStatus
: stringStatus to which the claim line has been processed, such as pending or denied
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| LineProcessingStatus |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| LineProcessingStatus |
"*Not Applicable" |
CMS ACO Part B DME File Load
| LineProcessingStatus |
|
||||||||
|
If CLM_PRCSG_IND_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimMedicareNonPaymentReasonCode" then "*Unknown" Otherwise if IsDenial = 1 then "Denied" Otherwise "Clean" |
CMS ACO Part B Physicians File Load
| LineProcessingStatus |
|
||||||||
|
If CLM_PRCSG_IND_CD is NULL then "*Unspecified" Otherwise if Id is NULL where CategoryName = "ClaimMedicareNonPaymentReasonCode" then "*Unknown" Otherwise if IsDenial = 1 then "Denied" Otherwise "Clean" |
CMS CJR DME Claim Procedure Load
| LineProcessingStatus |
NULL |
CMS CJR Home Health Claim Procedure Load
| LineProcessingStatus |
NULL |
CMS CJR Inpatient Claim Procedure Load
| LineProcessingStatus |
NULL |
CMS CJR Outpatient Claim Procedure Load
| LineProcessingStatus |
NULL |
CMS CJR Part B Claim Procedure Load
| LineProcessingStatus |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| LineProcessingStatus |
NULL |
CMS CJR Surgical Procedure Load
| LineProcessingStatus |
NULL |
Data Aggregation ICD Procedure Load
| LineProcessingStatus |
|
||||||
|
If AP_CLAIM.STATUS_C is NULL then *Unspecified Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then *Unknown Otherwise ZC_CLM_STATUS.NAME |
Data Aggregation Service Line Load
| LineProcessingStatus |
|
||||||||||||
|
If STATUS_4_C.NAME is not NULL then STATUS_4_C.NAME Otherwise if AP_CLAIM_PROC.STATUS_C is NULL then "*Unknown" Otherwise if AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME |
Externally Adjudicated ICD Procedure Load
| LineProcessingStatus |
|
||||||
|
If AP_CLAIM.STATUS_C is NULL then *Unspecified Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then *Unknown Otherwise ZC_CLM_STATUS.NAME |
Externally Adjudicated Service Line Load
| LineProcessingStatus |
|
||||||||||||
|
If STATUS_4_C.NAME is not NULL then STATUS_4_C.NAME Otherwise if AP_CLAIM_PROC.STATUS_C is NULL then "*Unknown" Otherwise if AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME |
Payer System ICD Procedure Load
| LineProcessingStatus |
|
||||||
|
If AP_CLAIM.STATUS_C is NULL then *Unspecified Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then *Unknown Otherwise ZC_CLM_STATUS.NAME |
Payer System Service Line Load
| LineProcessingStatus |
|
||||||||||||
|
If STATUS_4_C.NAME is not NULL then STATUS_4_C.NAME Otherwise if AP_CLAIM_PROC.STATUS_C is NULL then "*Unknown" Otherwise if AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME |
Received Claim ICD Procedure Load
| LineProcessingStatus |
|
||||||
|
If AP_CLAIM.STATUS_C is NULL then *Unspecified Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then *Unknown Otherwise ZC_CLM_STATUS.NAME |
Received Claim Procedure Load
| LineProcessingStatus |
|
||||||||||||
|
If STATUS_4_C.NAME is not NULL then STATUS_4_C.NAME Otherwise if AP_CLAIM_PROC.STATUS_C is NULL then "*Unknown" Otherwise if AP_CLAIM.STATUS_C is NULL then "*Unspecified" Otherwise if ZC_CLM_STATUS.CLAIM_STATUS_C is NULL then "*Unknown" Otherwise ZC_CLM_STATUS.NAME |
TaxIdNumber
: stringTaxpayer identification number associated with the claim. This number identifies who receives payment for the claim.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- empty string
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| TaxIdNumber |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| TaxIdNumber |
"*Not Applicable" |
CMS ACO Part B DME File Load
| TaxIdNumber |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| TaxIdNumber |
|
||
CMS CJR DME Claim Procedure Load
| TaxIdNumber |
NULL |
CMS CJR Home Health Claim Procedure Load
| TaxIdNumber |
NULL |
CMS CJR Inpatient Claim Procedure Load
| TaxIdNumber |
NULL |
CMS CJR Outpatient Claim Procedure Load
| TaxIdNumber |
NULL |
CMS CJR Part B Claim Procedure Load
| TaxIdNumber |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| TaxIdNumber |
NULL |
CMS CJR Surgical Procedure Load
| TaxIdNumber |
NULL |
Data Aggregation ICD Procedure Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Data Aggregation Service Line Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Externally Adjudicated ICD Procedure Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Externally Adjudicated Service Line Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Payer System ICD Procedure Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Payer System Service Line Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Received Claim ICD Procedure Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Received Claim Procedure Load
| TaxIdNumber |
|
||||
|
If BIL_PROV_TAXID is NULL THEN TAX_ID Otherwise BIL_PROV_TAXID |
Ccn
: stringCenters for Medicare and Medicaid Services Certification Number (CCN) for the claim location
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- empty string
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| Ccn |
|
||
CMS ACO Part A Procedure Files Load
| Ccn |
|
||
CMS ACO Part B DME File Load
| Ccn |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| Ccn |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| Ccn |
NULL |
CMS CJR Home Health Claim Procedure Load
| Ccn |
|
||
CMS CJR Inpatient Claim Procedure Load
| Ccn |
|
||
CMS CJR Outpatient Claim Procedure Load
| Ccn |
|
||
CMS CJR Part B Claim Procedure Load
| Ccn |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| Ccn |
|
||
CMS CJR Surgical Procedure Load
| Ccn |
|
||||||
|
If claim is inpatient, skilled nursing, or hospice then CLM_PROVIDER Otherwise NULL |
Data Aggregation ICD Procedure Load
| Ccn |
|
||
|
NULL |
Data Aggregation Service Line Load
| Ccn |
|
||
|
NULL |
Externally Adjudicated ICD Procedure Load
| Ccn |
NULL |
Externally Adjudicated Service Line Load
| Ccn |
NULL |
Payer System ICD Procedure Load
| Ccn |
|
||
|
NULL |
Payer System Service Line Load
| Ccn |
|
||
|
NULL |
Received Claim ICD Procedure Load
| Ccn |
NULL |
Received Claim Procedure Load
| Ccn |
NULL |
ServiceLineFacilityNpi
: stringNational Provider Identifier (NPI) of the service line facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceLineFacilityNpi |
CMS ACO Part A Procedure Files Load
| ServiceLineFacilityNpi |
CMS ACO Part B DME File Load
| ServiceLineFacilityNpi |
CMS ACO Part B Physicians File Load
| ServiceLineFacilityNpi |
CMS CJR DME Claim Procedure Load
| ServiceLineFacilityNpi |
CMS CJR Home Health Claim Procedure Load
| ServiceLineFacilityNpi |
CMS CJR Inpatient Claim Procedure Load
| ServiceLineFacilityNpi |
CMS CJR Outpatient Claim Procedure Load
| ServiceLineFacilityNpi |
CMS CJR Part B Claim Procedure Load
| ServiceLineFacilityNpi |
CMS CJR Skilled Nursing Claim Procedure Load
| ServiceLineFacilityNpi |
CMS CJR Surgical Procedure Load
| ServiceLineFacilityNpi |
Data Aggregation Service Line Load
| ServiceLineFacilityNpi |
|
||
Externally Adjudicated ICD Procedure Load
| ServiceLineFacilityNpi |
"*Not Applicable" |
Externally Adjudicated Service Line Load
| ServiceLineFacilityNpi |
|
||
Payer System Service Line Load
| ServiceLineFacilityNpi |
|
||
Received Claim ICD Procedure Load
| ServiceLineFacilityNpi |
Received Claim Procedure Load
| ServiceLineFacilityNpi |
|
||||||||
|
If the number of services has not been modified in the system then LN_SVC_FAC_NPI |
ServiceLineFacilityName
: stringName of the service line facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceLineFacilityName |
CMS ACO Part A Procedure Files Load
| ServiceLineFacilityName |
CMS ACO Part B DME File Load
| ServiceLineFacilityName |
CMS ACO Part B Physicians File Load
| ServiceLineFacilityName |
CMS CJR DME Claim Procedure Load
| ServiceLineFacilityName |
CMS CJR Home Health Claim Procedure Load
| ServiceLineFacilityName |
CMS CJR Inpatient Claim Procedure Load
| ServiceLineFacilityName |
CMS CJR Outpatient Claim Procedure Load
| ServiceLineFacilityName |
CMS CJR Part B Claim Procedure Load
| ServiceLineFacilityName |
CMS CJR Skilled Nursing Claim Procedure Load
| ServiceLineFacilityName |
CMS CJR Surgical Procedure Load
| ServiceLineFacilityName |
Data Aggregation Service Line Load
| ServiceLineFacilityName |
|
||
Externally Adjudicated ICD Procedure Load
| ServiceLineFacilityName |
"*Not Applicable" |
Externally Adjudicated Service Line Load
| ServiceLineFacilityName |
|
||
Payer System Service Line Load
| ServiceLineFacilityName |
|
||
Received Claim ICD Procedure Load
| ServiceLineFacilityName |
"*Not Applicable" |
Received Claim Procedure Load
| ServiceLineFacilityName |
|
||||||||
|
If the number of services has not been modified in the system then LN_SVC_FAC_NAM |
ServiceLineFacilityAddress
: stringAddress of the service line facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(250)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceLineFacilityAddress |
CMS ACO Part A Procedure Files Load
| ServiceLineFacilityAddress |
CMS ACO Part B DME File Load
| ServiceLineFacilityAddress |
CMS ACO Part B Physicians File Load
| ServiceLineFacilityAddress |
CMS CJR DME Claim Procedure Load
| ServiceLineFacilityAddress |
CMS CJR Home Health Claim Procedure Load
| ServiceLineFacilityAddress |
CMS CJR Inpatient Claim Procedure Load
| ServiceLineFacilityAddress |
CMS CJR Outpatient Claim Procedure Load
| ServiceLineFacilityAddress |
CMS CJR Part B Claim Procedure Load
| ServiceLineFacilityAddress |
CMS CJR Skilled Nursing Claim Procedure Load
| ServiceLineFacilityAddress |
CMS CJR Surgical Procedure Load
| ServiceLineFacilityAddress |
Data Aggregation Service Line Load
| ServiceLineFacilityAddress |
|
||||
|
If LN_SVC_FAC_ADDR_1 is NULL then LN_SVC_FAC_ADDR_2 Otherwise if LN_SVC_FAC_ADDR_2 is NULL then LN_SVC_FAC_ADDR_1 Otherwise LN_SVC_FAC_ADDR_1 + " " + LN_SVC_FAC_ADDR_2 |
Externally Adjudicated ICD Procedure Load
| ServiceLineFacilityAddress |
"*Not Applicable" |
Externally Adjudicated Service Line Load
| ServiceLineFacilityAddress |
|
||||
|
If LN_SVC_FAC_ADDR_1 is NULL then LN_SVC_FAC_ADDR_2 Otherwise if LN_SVC_FAC_ADDR_2 is NULL then LN_SVC_FAC_ADDR_1 Otherwise LN_SVC_FAC_ADDR_1 + " " + LN_SVC_FAC_ADDR_2 |
Payer System Service Line Load
| ServiceLineFacilityAddress |
|
||||
|
If LN_SVC_FAC_ADDR_1 is NULL then LN_SVC_FAC_ADDR_2 Otherwise if LN_SVC_FAC_ADDR_2 is NULL then LN_SVC_FAC_ADDR_1 Otherwise LN_SVC_FAC_ADDR_1 + " " + LN_SVC_FAC_ADDR_2 |
Received Claim ICD Procedure Load
| ServiceLineFacilityAddress |
"*Not Applicable" |
Received Claim Procedure Load
| ServiceLineFacilityAddress |
|
||||||||||
|
If LN_SVC_FAC_ADDR_1 is NULL and the number of services has not been modified in the system then LN_SVC_FAC_ADDR_2 Otherwise if LN_SVC_FAC_ADDR_2 is NULL and the number of services has not been modified in the system then LN_SVC_FAC_ADDR_1 Otherwise if the number of services has not been modified in the system then LN_SVC_FAC_ADDR_1 + " " + LN_SVC_FAC_ADDR_2 |
ServiceLineFacilityCity
: stringCity of the service line facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(100)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceLineFacilityCity |
CMS ACO Part A Procedure Files Load
| ServiceLineFacilityCity |
CMS ACO Part B DME File Load
| ServiceLineFacilityCity |
CMS ACO Part B Physicians File Load
| ServiceLineFacilityCity |
CMS CJR DME Claim Procedure Load
| ServiceLineFacilityCity |
CMS CJR Home Health Claim Procedure Load
| ServiceLineFacilityCity |
CMS CJR Inpatient Claim Procedure Load
| ServiceLineFacilityCity |
CMS CJR Outpatient Claim Procedure Load
| ServiceLineFacilityCity |
CMS CJR Part B Claim Procedure Load
| ServiceLineFacilityCity |
CMS CJR Skilled Nursing Claim Procedure Load
| ServiceLineFacilityCity |
CMS CJR Surgical Procedure Load
| ServiceLineFacilityCity |
Data Aggregation Service Line Load
| ServiceLineFacilityCity |
|
||
Externally Adjudicated ICD Procedure Load
| ServiceLineFacilityCity |
"*Not Applicable" |
Externally Adjudicated Service Line Load
| ServiceLineFacilityCity |
|
||
Payer System Service Line Load
| ServiceLineFacilityCity |
|
||
Received Claim ICD Procedure Load
| ServiceLineFacilityCity |
"*Not Applicable" |
Received Claim Procedure Load
| ServiceLineFacilityCity |
|
||||||||
|
If the number of services has not been modified in the system then LN_SVC_FAC_CITY |
ServiceLineFacilityStateOrProvince
: stringState or province of the service line facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceLineFacilityStateOrProvince |
CMS ACO Part A Procedure Files Load
| ServiceLineFacilityStateOrProvince |
CMS ACO Part B DME File Load
| ServiceLineFacilityStateOrProvince |
CMS ACO Part B Physicians File Load
| ServiceLineFacilityStateOrProvince |
CMS CJR DME Claim Procedure Load
| ServiceLineFacilityStateOrProvince |
CMS CJR Home Health Claim Procedure Load
| ServiceLineFacilityStateOrProvince |
CMS CJR Inpatient Claim Procedure Load
| ServiceLineFacilityStateOrProvince |
CMS CJR Outpatient Claim Procedure Load
| ServiceLineFacilityStateOrProvince |
CMS CJR Part B Claim Procedure Load
| ServiceLineFacilityStateOrProvince |
CMS CJR Skilled Nursing Claim Procedure Load
| ServiceLineFacilityStateOrProvince |
CMS CJR Surgical Procedure Load
| ServiceLineFacilityStateOrProvince |
Data Aggregation Service Line Load
| ServiceLineFacilityStateOrProvince |
|
||
Externally Adjudicated ICD Procedure Load
| ServiceLineFacilityStateOrProvince |
"*Not Applicable" |
Externally Adjudicated Service Line Load
| ServiceLineFacilityStateOrProvince |
|
||
Payer System Service Line Load
| ServiceLineFacilityStateOrProvince |
|
||
Received Claim ICD Procedure Load
| ServiceLineFacilityStateOrProvince |
"*Not Applicable" |
Received Claim Procedure Load
| ServiceLineFacilityStateOrProvince |
|
||||||||
|
If the number of services has not been modified in the system then LN_SVC_FAC_STATE |
ServiceLineFacilityPostalCode
: stringPostal code of the service line facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceLineFacilityPostalCode |
CMS ACO Part A Procedure Files Load
| ServiceLineFacilityPostalCode |
CMS ACO Part B DME File Load
| ServiceLineFacilityPostalCode |
CMS ACO Part B Physicians File Load
| ServiceLineFacilityPostalCode |
CMS CJR DME Claim Procedure Load
| ServiceLineFacilityPostalCode |
CMS CJR Home Health Claim Procedure Load
| ServiceLineFacilityPostalCode |
CMS CJR Inpatient Claim Procedure Load
| ServiceLineFacilityPostalCode |
CMS CJR Outpatient Claim Procedure Load
| ServiceLineFacilityPostalCode |
CMS CJR Part B Claim Procedure Load
| ServiceLineFacilityPostalCode |
CMS CJR Skilled Nursing Claim Procedure Load
| ServiceLineFacilityPostalCode |
CMS CJR Surgical Procedure Load
| ServiceLineFacilityPostalCode |
Data Aggregation Service Line Load
| ServiceLineFacilityPostalCode |
|
||
Externally Adjudicated ICD Procedure Load
| ServiceLineFacilityPostalCode |
"*Not Applicable" |
Externally Adjudicated Service Line Load
| ServiceLineFacilityPostalCode |
|
||
Payer System Service Line Load
| ServiceLineFacilityPostalCode |
|
||
Received Claim ICD Procedure Load
| ServiceLineFacilityPostalCode |
"*Not Applicable" |
Received Claim Procedure Load
| ServiceLineFacilityPostalCode |
|
||||||||
|
If the number of services has not been modified in the system then LN_SVC_FAC_ZIP |
ServiceLineFacilityCountry
: stringCountry of the service line facility as received on the claim
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| ServiceLineFacilityCountry |
CMS ACO Part A Procedure Files Load
| ServiceLineFacilityCountry |
CMS ACO Part B DME File Load
| ServiceLineFacilityCountry |
CMS ACO Part B Physicians File Load
| ServiceLineFacilityCountry |
CMS CJR DME Claim Procedure Load
| ServiceLineFacilityCountry |
CMS CJR Home Health Claim Procedure Load
| ServiceLineFacilityCountry |
CMS CJR Inpatient Claim Procedure Load
| ServiceLineFacilityCountry |
CMS CJR Outpatient Claim Procedure Load
| ServiceLineFacilityCountry |
CMS CJR Part B Claim Procedure Load
| ServiceLineFacilityCountry |
CMS CJR Skilled Nursing Claim Procedure Load
| ServiceLineFacilityCountry |
CMS CJR Surgical Procedure Load
| ServiceLineFacilityCountry |
Data Aggregation Service Line Load
| ServiceLineFacilityCountry |
|
||
Externally Adjudicated ICD Procedure Load
| ServiceLineFacilityCountry |
"*Not Applicable" |
Externally Adjudicated Service Line Load
| ServiceLineFacilityCountry |
|
||
Payer System Service Line Load
| ServiceLineFacilityCountry |
|
||
Received Claim ICD Procedure Load
| ServiceLineFacilityCountry |
"*Not Applicable" |
Received Claim Procedure Load
| ServiceLineFacilityCountry |
|
||||||||
|
If the number of services has not been modified in the system then LN_SVC_FAC_CNTRY |
DetailedServiceClass
: stringThe service classification for this claim line, based on the Claim Line Service Classification Mapping Table in your system definitions. Only contains data if you use the Chronicles Claims Loader.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(300)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- *Deleted
Data Lineage for Each Package
CMS ACO Part A Files Load
| DetailedServiceClass |
"*Not Applicable" |
CMS ACO Part A Procedure Files Load
| DetailedServiceClass |
"*Not Applicable" |
CMS ACO Part B DME File Load
| DetailedServiceClass |
"*Not Applicable" |
CMS ACO Part B Physicians File Load
| DetailedServiceClass |
"*Not Applicable" |
CMS CJR DME Claim Procedure Load
| DetailedServiceClass |
"*Not Applicable" |
CMS CJR Home Health Claim Procedure Load
| DetailedServiceClass |
"*Not Applicable" |
CMS CJR Inpatient Claim Procedure Load
| DetailedServiceClass |
"*Not Applicable" |
CMS CJR Outpatient Claim Procedure Load
| DetailedServiceClass |
"*Not Applicable" |
CMS CJR Part B Claim Procedure Load
| DetailedServiceClass |
"*Not Applicable" |
CMS CJR Skilled Nursing Claim Procedure Load
| DetailedServiceClass |
"*Not Applicable" |
CMS CJR Surgical Procedure Load
| DetailedServiceClass |
"*Not Applicable" |
Data Aggregation Service Line Load
| DetailedServiceClass |
|
||||||
Externally Adjudicated ICD Procedure Load
| DetailedServiceClass |
"*Not Applicable" |
Externally Adjudicated Service Line Load
| DetailedServiceClass |
|
||||||
|
If AP_CLAIM_PROC_2.CLAIM_LN_DTL_SVC_CLASS_C is NULL then "*Unspecified" Otherwise if ZC_CLAIM_LN_DTL_SVC_CLASS.CLAIM_LN_DTL_SVC_CLASS_C is NULL then "*Unknown" Otherwise ZC_CLAIM_LN_DTL_SVC_CLASS.NAME |
Payer System Service Line Load
| DetailedServiceClass |
|
||||||
Received Claim ICD Procedure Load
| DetailedServiceClass |
"*Not Applicable" |
Received Claim Procedure Load
| DetailedServiceClass |
|
||||||
|
If AP_CLAIM_PROC_2.CLAIM_LN_DTL_SVC_CLASS_C is NULL then "*Unspecified" Otherwise if ZC_CLAIM_LN_DTL_SVC_CLASS.CLAIM_LN_DTL_SVC_CLASS_C is NULL then "*Unknown" Otherwise ZC_CLAIM_LN_DTL_SVC_CLASS.NAME |
TypeOfBillFacilityTypeCode
: integerFirst digit of the type of bill code. This indicates the type of facility.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS ACO Part A Procedure Files Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS ACO Part B DME File Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS ACO Part B Physicians File Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR DME Claim Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Home Health Claim Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Inpatient Claim Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Outpatient Claim Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Part B Claim Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
CMS CJR Surgical Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
Data Aggregation ICD Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
Data Aggregation Service Line Load
| TypeOfBillFacilityTypeCode |
NULL |
Externally Adjudicated ICD Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
Externally Adjudicated Service Line Load
| TypeOfBillFacilityTypeCode |
NULL |
Payer System ICD Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
Payer System Service Line Load
| TypeOfBillFacilityTypeCode |
NULL |
Received Claim ICD Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
Received Claim Procedure Load
| TypeOfBillFacilityTypeCode |
NULL |
TypeOfBillServiceTypeCode
: integerSecond digit of the type of bill code. This indicates the type of service provided.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| TypeOfBillServiceTypeCode |
NULL |
CMS ACO Part A Procedure Files Load
| TypeOfBillServiceTypeCode |
NULL |
CMS ACO Part B DME File Load
| TypeOfBillServiceTypeCode |
NULL |
CMS ACO Part B Physicians File Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR DME Claim Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Home Health Claim Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Inpatient Claim Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Outpatient Claim Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Part B Claim Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
CMS CJR Surgical Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
Data Aggregation ICD Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
Data Aggregation Service Line Load
| TypeOfBillServiceTypeCode |
NULL |
Externally Adjudicated ICD Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
Externally Adjudicated Service Line Load
| TypeOfBillServiceTypeCode |
NULL |
Payer System ICD Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
Payer System Service Line Load
| TypeOfBillServiceTypeCode |
NULL |
Received Claim ICD Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
Received Claim Procedure Load
| TypeOfBillServiceTypeCode |
NULL |
TypeOfBillFrequencyCode
: stringThird digit of the type of bill code. This indicates the timing of the claim.
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- empty string
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| TypeOfBillFrequencyCode |
NULL |
CMS ACO Part A Procedure Files Load
| TypeOfBillFrequencyCode |
NULL |
CMS ACO Part B DME File Load
| TypeOfBillFrequencyCode |
NULL |
CMS ACO Part B Physicians File Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR DME Claim Procedure Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Home Health Claim Procedure Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Inpatient Claim Procedure Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Outpatient Claim Procedure Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Part B Claim Procedure Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| TypeOfBillFrequencyCode |
NULL |
CMS CJR Surgical Procedure Load
| TypeOfBillFrequencyCode |
NULL |
Data Aggregation ICD Procedure Load
| TypeOfBillFrequencyCode |
NULL |
Data Aggregation Service Line Load
| TypeOfBillFrequencyCode |
NULL |
Externally Adjudicated ICD Procedure Load
| TypeOfBillFrequencyCode |
NULL |
Externally Adjudicated Service Line Load
| TypeOfBillFrequencyCode |
NULL |
Payer System ICD Procedure Load
| TypeOfBillFrequencyCode |
NULL |
Payer System Service Line Load
| TypeOfBillFrequencyCode |
NULL |
Received Claim ICD Procedure Load
| TypeOfBillFrequencyCode |
NULL |
Received Claim Procedure Load
| TypeOfBillFrequencyCode |
NULL |
PlaceOfServiceTypeCode
: stringCenters for Medicare & Medicaid Services (CMS) code for the place of service where the procedure was performed
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- empty string
- Delete value
- empty string
Data Lineage for Each Package
CMS ACO Part A Files Load
| PlaceOfServiceTypeCode |
NULL |
CMS ACO Part A Procedure Files Load
| PlaceOfServiceTypeCode |
"*Not Applicable" |
CMS ACO Part B DME File Load
| PlaceOfServiceTypeCode |
|
||
CMS ACO Part B Physicians File Load
| PlaceOfServiceTypeCode |
|
||
CMS CJR DME Claim Procedure Load
| PlaceOfServiceTypeCode |
|
||
CMS CJR Home Health Claim Procedure Load
| PlaceOfServiceTypeCode |
NULL |
CMS CJR Inpatient Claim Procedure Load
| PlaceOfServiceTypeCode |
NULL |
CMS CJR Outpatient Claim Procedure Load
| PlaceOfServiceTypeCode |
NULL |
CMS CJR Part B Claim Procedure Load
| PlaceOfServiceTypeCode |
CmsCjrPartBDetail.PLCSRVC |
CMS CJR Skilled Nursing Claim Procedure Load
| PlaceOfServiceTypeCode |
NULL |
CMS CJR Surgical Procedure Load
| PlaceOfServiceTypeCode |
NULL |
Data Aggregation ICD Procedure Load
| PlaceOfServiceTypeCode |
NULL |
Data Aggregation Service Line Load
| PlaceOfServiceTypeCode |
|
||||
Externally Adjudicated ICD Procedure Load
| PlaceOfServiceTypeCode |
NULL |
Externally Adjudicated Service Line Load
| PlaceOfServiceTypeCode |
|
||||
Payer System ICD Procedure Load
| PlaceOfServiceTypeCode |
NULL |
Payer System Service Line Load
| PlaceOfServiceTypeCode |
|
||||
Received Claim ICD Procedure Load
| PlaceOfServiceTypeCode |
NULL |
Received Claim Procedure Load
| PlaceOfServiceTypeCode |
|
||||
IcdProcedureRank
: integerThe rank of the ICD procedure in relation to other ICD procedures on the same claim
Properties
- Data type
- integer
- SQL Server data type
- int
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| IcdProcedureRank |
NULL |
CMS ACO Part A Procedure Files Load
| IcdProcedureRank |
|
||
CMS ACO Part B DME File Load
| IcdProcedureRank |
NULL |
CMS ACO Part B Physicians File Load
| IcdProcedureRank |
NULL |
CMS CJR DME Claim Procedure Load
| IcdProcedureRank |
NULL |
CMS CJR Home Health Claim Procedure Load
| IcdProcedureRank |
NULL |
CMS CJR Inpatient Claim Procedure Load
| IcdProcedureRank |
NULL |
CMS CJR Outpatient Claim Procedure Load
| IcdProcedureRank |
NULL |
CMS CJR Part B Claim Procedure Load
| IcdProcedureRank |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| IcdProcedureRank |
NULL |
CMS CJR Surgical Procedure Load
| IcdProcedureRank |
|
||
Data Aggregation ICD Procedure Load
| IcdProcedureRank |
|
||
Data Aggregation Service Line Load
| IcdProcedureRank |
NULL |
Externally Adjudicated ICD Procedure Load
| IcdProcedureRank |
|
||
Externally Adjudicated Service Line Load
| IcdProcedureRank |
NULL |
Payer System ICD Procedure Load
| IcdProcedureRank |
|
||
Payer System Service Line Load
| IcdProcedureRank |
NULL |
Received Claim ICD Procedure Load
| IcdProcedureRank |
|
||
Received Claim Procedure Load
| IcdProcedureRank |
NULL |
Quantity
: numberNumber of times the procedure was used or performed. Negative numbers indicate reversed claims.
Properties
- Data type
- number
- SQL Server data type
- numeric(18,4)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| Quantity |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_ALOWD_UNIT_QTY × (-1) Otherwise CLM_LINE_ALOWD_UNIT_QTY |
CMS ACO Part A Procedure Files Load
| Quantity |
NULL |
CMS ACO Part B DME File Load
| Quantity |
NULL |
CMS ACO Part B Physicians File Load
| Quantity |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_ALOWD_UNIT_QTY × (-1) Otherwise CLM_LINE_ALOWD_UNIT_QTY |
CMS CJR DME Claim Procedure Load
| Quantity |
|
||
CMS CJR Home Health Claim Procedure Load
| Quantity |
|
||
CMS CJR Inpatient Claim Procedure Load
| Quantity |
|
||
CMS CJR Outpatient Claim Procedure Load
| Quantity |
|
||
CMS CJR Part B Claim Procedure Load
| Quantity |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| Quantity |
|
||
CMS CJR Surgical Procedure Load
| Quantity |
NULL |
Data Aggregation Service Line Load
| Quantity |
|
||
Externally Adjudicated ICD Procedure Load
| Quantity |
NULL |
Externally Adjudicated Service Line Load
| Quantity |
|
||
Payer System Service Line Load
| Quantity |
|
||
Received Claim ICD Procedure Load
| Quantity |
NULL |
Received Claim Procedure Load
| Quantity |
|
||
BilledAmount
: numberBilled amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| BilledAmount |
NULL |
CMS ACO Part A Procedure Files Load
| BilledAmount |
NULL |
CMS ACO Part B DME File Load
| BilledAmount |
NULL |
CMS ACO Part B Physicians File Load
| BilledAmount |
NULL |
CMS CJR DME Claim Procedure Load
| BilledAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| BilledAmount |
|
||
CMS CJR Inpatient Claim Procedure Load
| BilledAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| BilledAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| BilledAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| BilledAmount |
NULL |
CMS CJR Surgical Procedure Load
| BilledAmount |
NULL |
Data Aggregation ICD Procedure Load
| BilledAmount |
NULL |
Data Aggregation Service Line Load
| BilledAmount |
|
||
Externally Adjudicated ICD Procedure Load
| BilledAmount |
NULL |
Externally Adjudicated Service Line Load
| BilledAmount |
|
||
Payer System ICD Procedure Load
| BilledAmount |
NULL |
Payer System Service Line Load
| BilledAmount |
|
||
Received Claim ICD Procedure Load
| BilledAmount |
NULL |
Received Claim Procedure Load
| BilledAmount |
|
||
DiscountAmount
: numberDiscount amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| DiscountAmount |
NULL |
CMS ACO Part A Procedure Files Load
| DiscountAmount |
NULL |
CMS ACO Part B DME File Load
| DiscountAmount |
NULL |
CMS ACO Part B Physicians File Load
| DiscountAmount |
NULL |
CMS CJR DME Claim Procedure Load
| DiscountAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| DiscountAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| DiscountAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| DiscountAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| DiscountAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| DiscountAmount |
NULL |
CMS CJR Surgical Procedure Load
| DiscountAmount |
NULL |
Data Aggregation ICD Procedure Load
| DiscountAmount |
NULL |
Data Aggregation Service Line Load
| DiscountAmount |
|
||
Externally Adjudicated ICD Procedure Load
| DiscountAmount |
NULL |
Externally Adjudicated Service Line Load
| DiscountAmount |
|
||
Payer System ICD Procedure Load
| DiscountAmount |
NULL |
Payer System Service Line Load
| DiscountAmount |
|
||
Received Claim ICD Procedure Load
| DiscountAmount |
NULL |
Received Claim Procedure Load
| DiscountAmount |
|
||
AllowedAmount
: numberAllowed amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| AllowedAmount |
NULL |
CMS ACO Part A Procedure Files Load
| AllowedAmount |
NULL |
CMS ACO Part B DME File Load
| AllowedAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_ALOWD_CHRG_AMT × (-1) Otherwise CLM_LINE_ALOWD_CHRG_AMT |
CMS ACO Part B Physicians File Load
| AllowedAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_ALOWD_CHRG_AMT × (-1) Otherwise CLM_LINE_ALOWD_CHRG_AMT |
CMS CJR DME Claim Procedure Load
| AllowedAmount |
|
||
CMS CJR Home Health Claim Procedure Load
| AllowedAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| AllowedAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| AllowedAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| AllowedAmount |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| AllowedAmount |
NULL |
CMS CJR Surgical Procedure Load
| AllowedAmount |
NULL |
Data Aggregation ICD Procedure Load
| AllowedAmount |
NULL |
Data Aggregation Service Line Load
| AllowedAmount |
|
||||
|
If OVERRIDE_ALLD_AMT is not NULL then OVERRIDE_ALLD_AMT Otherwise ALLOWED_AMT |
Externally Adjudicated ICD Procedure Load
| AllowedAmount |
NULL |
Externally Adjudicated Service Line Load
| AllowedAmount |
|
||||
|
If OVERRIDE_ALLD_AMT is not NULL then OVERRIDE_ALLD_AMT Otherwise ALLOWED_AMT |
Payer System ICD Procedure Load
| AllowedAmount |
NULL |
Payer System Service Line Load
| AllowedAmount |
|
||||
|
If OVERRIDE_ALLD_AMT is not NULL then OVERRIDE_ALLD_AMT Otherwise ALLOWED_AMT |
Received Claim ICD Procedure Load
| AllowedAmount |
NULL |
Received Claim Procedure Load
| AllowedAmount |
|
||||
|
If OVERRIDE_ALLD_AMT is not NULL then OVERRIDE_ALLD_AMT Otherwise ALLOWED_AMT |
CopayAmount
: numberCopay amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| CopayAmount |
NULL |
CMS ACO Part A Procedure Files Load
| CopayAmount |
NULL |
CMS ACO Part B DME File Load
| CopayAmount |
NULL |
CMS ACO Part B Physicians File Load
| CopayAmount |
NULL |
CMS CJR DME Claim Procedure Load
| CopayAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| CopayAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| CopayAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| CopayAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| CopayAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| CopayAmount |
NULL |
CMS CJR Surgical Procedure Load
| CopayAmount |
NULL |
Data Aggregation ICD Procedure Load
| CopayAmount |
NULL |
Data Aggregation Service Line Load
| CopayAmount |
|
||||
|
If OVRD_COPAY is not NULL then OVRD_COPAY Otherwise COPAYMENT |
Externally Adjudicated ICD Procedure Load
| CopayAmount |
NULL |
Externally Adjudicated Service Line Load
| CopayAmount |
|
||||
|
If OVRD_COPAY is not NULL then OVRD_COPAY Otherwise COPAYMENT |
Payer System ICD Procedure Load
| CopayAmount |
NULL |
Payer System Service Line Load
| CopayAmount |
|
||||
|
If OVRD_COPAY is not NULL then OVRD_COPAY Otherwise COPAYMENT |
Received Claim ICD Procedure Load
| CopayAmount |
NULL |
Received Claim Procedure Load
| CopayAmount |
|
||||
|
If OVRD_COPAY is not NULL then OVRD_COPAY Otherwise COPAYMENT |
CoinsuranceAmount
: numberCo-insurance amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| CoinsuranceAmount |
NULL |
CMS ACO Part A Procedure Files Load
| CoinsuranceAmount |
NULL |
CMS ACO Part B DME File Load
| CoinsuranceAmount |
NULL |
CMS ACO Part B Physicians File Load
| CoinsuranceAmount |
NULL |
CMS CJR DME Claim Procedure Load
| CoinsuranceAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| CoinsuranceAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| CoinsuranceAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| CoinsuranceAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| CoinsuranceAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| CoinsuranceAmount |
NULL |
CMS CJR Surgical Procedure Load
| CoinsuranceAmount |
NULL |
Data Aggregation ICD Procedure Load
| CoinsuranceAmount |
NULL |
Data Aggregation Service Line Load
| CoinsuranceAmount |
|
||||
|
If OVRD_COINS is not NULL then OVRD_COINS Otherwise COINSURANCE |
Externally Adjudicated ICD Procedure Load
| CoinsuranceAmount |
NULL |
Externally Adjudicated Service Line Load
| CoinsuranceAmount |
|
||||
|
If OVRD_COINS is not NULL then OVRD_COINS Otherwise COINSURANCE |
Payer System ICD Procedure Load
| CoinsuranceAmount |
NULL |
Payer System Service Line Load
| CoinsuranceAmount |
|
||||
|
If OVRD_COINS is not NULL then OVRD_COINS Otherwise COINSURANCE |
Received Claim ICD Procedure Load
| CoinsuranceAmount |
NULL |
Received Claim Procedure Load
| CoinsuranceAmount |
|
||||
|
If OVRD_COINS is not NULL then OVRD_COINS Otherwise COINSURANCE |
DeductibleAmount
: numberDeductible amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| DeductibleAmount |
NULL |
CMS ACO Part A Procedure Files Load
| DeductibleAmount |
NULL |
CMS ACO Part B DME File Load
| DeductibleAmount |
NULL |
CMS ACO Part B Physicians File Load
| DeductibleAmount |
NULL |
CMS CJR DME Claim Procedure Load
| DeductibleAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| DeductibleAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| DeductibleAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| DeductibleAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| DeductibleAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| DeductibleAmount |
NULL |
CMS CJR Surgical Procedure Load
| DeductibleAmount |
NULL |
Data Aggregation ICD Procedure Load
| DeductibleAmount |
NULL |
Data Aggregation Service Line Load
| DeductibleAmount |
|
||||
|
If OVRD_DEDUCTIBLE is not NULL then OVRD_DEDUCTIBLE Otherwise DEDUCTIBLE |
Externally Adjudicated ICD Procedure Load
| DeductibleAmount |
NULL |
Externally Adjudicated Service Line Load
| DeductibleAmount |
|
||||
|
If OVRD_DEDUCTIBLE is not NULL then OVRD_DEDUCTIBLE Otherwise DEDUCTIBLE |
Payer System ICD Procedure Load
| DeductibleAmount |
NULL |
Payer System Service Line Load
| DeductibleAmount |
|
||||
|
If OVRD_DEDUCTIBLE is not NULL then OVRD_DEDUCTIBLE Otherwise DEDUCTIBLE |
Received Claim ICD Procedure Load
| DeductibleAmount |
NULL |
Received Claim Procedure Load
| DeductibleAmount |
|
||||
|
If OVRD_DEDUCTIBLE is not NULL then OVRD_DEDUCTIBLE Otherwise DEDUCTIBLE |
NotCoveredAmount
: numberAmount not covered associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| NotCoveredAmount |
NULL |
CMS ACO Part A Procedure Files Load
| NotCoveredAmount |
NULL |
CMS ACO Part B DME File Load
| NotCoveredAmount |
NULL |
CMS ACO Part B Physicians File Load
| NotCoveredAmount |
NULL |
CMS CJR DME Claim Procedure Load
| NotCoveredAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| NotCoveredAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| NotCoveredAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| NotCoveredAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| NotCoveredAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| NotCoveredAmount |
NULL |
CMS CJR Surgical Procedure Load
| NotCoveredAmount |
NULL |
Data Aggregation ICD Procedure Load
| NotCoveredAmount |
NULL |
Data Aggregation Service Line Load
| NotCoveredAmount |
|
||||
|
If OVRD_NOT_CVD is not NULL then OVRD_NOT_CVD Otherwise NON_CVD_AMT |
Externally Adjudicated ICD Procedure Load
| NotCoveredAmount |
NULL |
Externally Adjudicated Service Line Load
| NotCoveredAmount |
|
||||
|
If OVRD_NOT_CVD is not NULL then OVRD_NOT_CVD Otherwise NON_CVD_AMT |
Payer System ICD Procedure Load
| NotCoveredAmount |
NULL |
Payer System Service Line Load
| NotCoveredAmount |
|
||||
|
If OVRD_NOT_CVD is not NULL then OVRD_NOT_CVD Otherwise NON_CVD_AMT |
Received Claim ICD Procedure Load
| NotCoveredAmount |
NULL |
Received Claim Procedure Load
| NotCoveredAmount |
|
||||
|
If OVRD_NOT_CVD is not NULL then OVRD_NOT_CVD Otherwise NON_CVD_AMT |
PatientPortionAmount
: numberAmount associated with the procedure the patient is responsible for paying. For Epic data, this is calculated as the sum of the copay, co-insurance, deductible and amount not covered.
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| PatientPortionAmount |
NULL |
CMS ACO Part A Procedure Files Load
| PatientPortionAmount |
NULL |
CMS ACO Part B DME File Load
| PatientPortionAmount |
NULL |
CMS ACO Part B Physicians File Load
| PatientPortionAmount |
NULL |
CMS CJR DME Claim Procedure Load
| PatientPortionAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| PatientPortionAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| PatientPortionAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| PatientPortionAmount |
|
||
CMS CJR Part B Claim Procedure Load
| PatientPortionAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| PatientPortionAmount |
NULL |
CMS CJR Surgical Procedure Load
| PatientPortionAmount |
NULL |
Data Aggregation ICD Procedure Load
| PatientPortionAmount |
NULL |
Data Aggregation Service Line Load
| PatientPortionAmount |
|
||||
|
If OVRD_PAT_PORT is not NULL then OVRD_PAT_PORT Otherwise PAT_PORTION |
Externally Adjudicated ICD Procedure Load
| PatientPortionAmount |
NULL |
Externally Adjudicated Service Line Load
| PatientPortionAmount |
|
||||
|
If OVRD_PAT_PORT is not NULL then OVRD_PAT_PORT Otherwise PAT_PORTION |
Payer System ICD Procedure Load
| PatientPortionAmount |
NULL |
Payer System Service Line Load
| PatientPortionAmount |
|
||||
|
If OVRD_PAT_PORT is not NULL then OVRD_PAT_PORT Otherwise PAT_PORTION |
Received Claim ICD Procedure Load
| PatientPortionAmount |
NULL |
Received Claim Procedure Load
| PatientPortionAmount |
|
||||
|
If OVRD_PAT_PORT is not NULL then OVRD_PAT_PORT Otherwise PAT_PORTION |
InsuranceAmount
: numberInsurance amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| InsuranceAmount |
NULL |
CMS ACO Part A Procedure Files Load
| InsuranceAmount |
NULL |
CMS ACO Part B DME File Load
| InsuranceAmount |
NULL |
CMS ACO Part B Physicians File Load
| InsuranceAmount |
NULL |
CMS CJR DME Claim Procedure Load
| InsuranceAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| InsuranceAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| InsuranceAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| InsuranceAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| InsuranceAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| InsuranceAmount |
NULL |
CMS CJR Surgical Procedure Load
| InsuranceAmount |
NULL |
Data Aggregation ICD Procedure Load
| InsuranceAmount |
NULL |
Data Aggregation Service Line Load
| InsuranceAmount |
|
||
Externally Adjudicated ICD Procedure Load
| InsuranceAmount |
NULL |
Externally Adjudicated Service Line Load
| InsuranceAmount |
|
||
Payer System ICD Procedure Load
| InsuranceAmount |
NULL |
Payer System Service Line Load
| InsuranceAmount |
|
||
Received Claim ICD Procedure Load
| InsuranceAmount |
NULL |
Received Claim Procedure Load
| InsuranceAmount |
|
||
AdjustmentAmount
: numberAdjustment amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| AdjustmentAmount |
NULL |
CMS ACO Part A Procedure Files Load
| AdjustmentAmount |
NULL |
CMS ACO Part B DME File Load
| AdjustmentAmount |
NULL |
CMS ACO Part B Physicians File Load
| AdjustmentAmount |
NULL |
CMS CJR DME Claim Procedure Load
| AdjustmentAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| AdjustmentAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| AdjustmentAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| AdjustmentAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| AdjustmentAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| AdjustmentAmount |
NULL |
CMS CJR Surgical Procedure Load
| AdjustmentAmount |
NULL |
Data Aggregation ICD Procedure Load
| AdjustmentAmount |
NULL |
Data Aggregation Service Line Load
| AdjustmentAmount |
|
||||
|
If ACTUAL_ADJUSTMENT is not NULL then ACTUAL_ADJUSTMENT Otherwise COMP_ADJUSTMENT |
Externally Adjudicated ICD Procedure Load
| AdjustmentAmount |
NULL |
Externally Adjudicated Service Line Load
| AdjustmentAmount |
|
||||
|
If ACTUAL_ADJUSTMENT is not NULL then ACTUAL_ADJUSTMENT Otherwise COMP_ADJUSTMENT |
Payer System ICD Procedure Load
| AdjustmentAmount |
NULL |
Payer System Service Line Load
| AdjustmentAmount |
|
||||
|
If ACTUAL_ADJUSTMENT is not NULL then ACTUAL_ADJUSTMENT Otherwise COMP_ADJUSTMENT |
Received Claim ICD Procedure Load
| AdjustmentAmount |
NULL |
Received Claim Procedure Load
| AdjustmentAmount |
|
||||
|
If ACTUAL_ADJUSTMENT is not NULL then ACTUAL_ADJUSTMENT Otherwise COMP_ADJUSTMENT |
NetInsuranceAmount
: numberNet insurance amount associated with the procedure remaining after deducting all applicable adjustments and other payments from the insurance amount
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| NetInsuranceAmount |
NULL |
CMS ACO Part A Procedure Files Load
| NetInsuranceAmount |
NULL |
CMS ACO Part B DME File Load
| NetInsuranceAmount |
NULL |
CMS ACO Part B Physicians File Load
| NetInsuranceAmount |
NULL |
CMS CJR DME Claim Procedure Load
| NetInsuranceAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| NetInsuranceAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| NetInsuranceAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| NetInsuranceAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| NetInsuranceAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| NetInsuranceAmount |
NULL |
CMS CJR Surgical Procedure Load
| NetInsuranceAmount |
NULL |
Data Aggregation ICD Procedure Load
| NetInsuranceAmount |
NULL |
Data Aggregation Service Line Load
| NetInsuranceAmount |
|
||
Externally Adjudicated ICD Procedure Load
| NetInsuranceAmount |
NULL |
Externally Adjudicated Service Line Load
| NetInsuranceAmount |
|
||
Payer System ICD Procedure Load
| NetInsuranceAmount |
NULL |
Payer System Service Line Load
| NetInsuranceAmount |
|
||
Received Claim ICD Procedure Load
| NetInsuranceAmount |
NULL |
Received Claim Procedure Load
| NetInsuranceAmount |
|
||
ExceededBenefitAmount
: numberAmount associated with the procedure that exceeded maximum benefit amount
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| ExceededBenefitAmount |
NULL |
CMS ACO Part A Procedure Files Load
| ExceededBenefitAmount |
NULL |
CMS ACO Part B DME File Load
| ExceededBenefitAmount |
NULL |
CMS ACO Part B Physicians File Load
| ExceededBenefitAmount |
NULL |
CMS CJR DME Claim Procedure Load
| ExceededBenefitAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| ExceededBenefitAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| ExceededBenefitAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| ExceededBenefitAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| ExceededBenefitAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| ExceededBenefitAmount |
NULL |
CMS CJR Surgical Procedure Load
| ExceededBenefitAmount |
NULL |
Data Aggregation ICD Procedure Load
| ExceededBenefitAmount |
NULL |
Data Aggregation Service Line Load
| ExceededBenefitAmount |
|
||||
|
If OVRD_EXCD_BEN_AMT is not NULL then OVRD_EXCD_BEN_AMT Otherwise EXCEEDED_BEN_AMT |
Externally Adjudicated ICD Procedure Load
| ExceededBenefitAmount |
NULL |
Externally Adjudicated Service Line Load
| ExceededBenefitAmount |
|
||||
|
If OVRD_EXCD_BEN_AMT is not NULL then OVRD_EXCD_BEN_AMT Otherwise EXCEEDED_BEN_AMT |
Payer System ICD Procedure Load
| ExceededBenefitAmount |
NULL |
Payer System Service Line Load
| ExceededBenefitAmount |
|
||||
|
If OVRD_EXCD_BEN_AMT is not NULL then OVRD_EXCD_BEN_AMT Otherwise EXCEEDED_BEN_AMT |
Received Claim ICD Procedure Load
| ExceededBenefitAmount |
NULL |
Received Claim Procedure Load
| ExceededBenefitAmount |
|
||||
|
If OVRD_EXCD_BEN_AMT is not NULL then OVRD_EXCD_BEN_AMT Otherwise EXCEEDED_BEN_AMT |
WithholdingAmount
: numberWithholding amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| WithholdingAmount |
NULL |
CMS ACO Part A Procedure Files Load
| WithholdingAmount |
NULL |
CMS ACO Part B DME File Load
| WithholdingAmount |
NULL |
CMS ACO Part B Physicians File Load
| WithholdingAmount |
NULL |
CMS CJR DME Claim Procedure Load
| WithholdingAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| WithholdingAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| WithholdingAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| WithholdingAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| WithholdingAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| WithholdingAmount |
NULL |
CMS CJR Surgical Procedure Load
| WithholdingAmount |
NULL |
Data Aggregation ICD Procedure Load
| WithholdingAmount |
NULL |
Data Aggregation Service Line Load
| WithholdingAmount |
|
||||
|
If WITHHOLDING is not NULL then WITHHOLDING Otherwise COMP_WITHHOLDING |
Externally Adjudicated ICD Procedure Load
| WithholdingAmount |
NULL |
Externally Adjudicated Service Line Load
| WithholdingAmount |
|
||||
|
If WITHHOLDING is not NULL then WITHHOLDING Otherwise COMP_WITHHOLDING |
Payer System ICD Procedure Load
| WithholdingAmount |
NULL |
Payer System Service Line Load
| WithholdingAmount |
|
||||
|
If WITHHOLDING is not NULL then WITHHOLDING Otherwise COMP_WITHHOLDING |
Received Claim ICD Procedure Load
| WithholdingAmount |
NULL |
Received Claim Procedure Load
| WithholdingAmount |
|
||||
|
If WITHHOLDING is not NULL then WITHHOLDING Otherwise COMP_WITHHOLDING |
NetPayableAmount
: numberNet payable amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| NetPayableAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_CVRD_PD_AMT × (-1) Otherwise CLM_LINE_CVRD_PD_AMT |
CMS ACO Part A Procedure Files Load
| NetPayableAmount |
NULL |
CMS ACO Part B DME File Load
| NetPayableAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_CVRD_PD_AMT × (-1) Otherwise CLM_LINE_CVRD_PD_AMT |
CMS ACO Part B Physicians File Load
| NetPayableAmount |
|
||||
|
If CLM_ADJSMT_TYPE_CD = 1 then CLM_LINE_CVRD_PD_AMT × (-1) Otherwise CLM_LINE_CVRD_PD_AMT |
CMS CJR DME Claim Procedure Load
| NetPayableAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| NetPayableAmount |
|
||
CMS CJR Inpatient Claim Procedure Load
| NetPayableAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| NetPayableAmount |
|
||
CMS CJR Part B Claim Procedure Load
| NetPayableAmount |
|
||
CMS CJR Skilled Nursing Claim Procedure Load
| NetPayableAmount |
NULL |
CMS CJR Surgical Procedure Load
| NetPayableAmount |
NULL |
Data Aggregation ICD Procedure Load
| NetPayableAmount |
NULL |
Data Aggregation Service Line Load
| NetPayableAmount |
|
||
Externally Adjudicated ICD Procedure Load
| NetPayableAmount |
NULL |
Externally Adjudicated Service Line Load
| NetPayableAmount |
|
||
Payer System ICD Procedure Load
| NetPayableAmount |
NULL |
Payer System Service Line Load
| NetPayableAmount |
|
||
Received Claim ICD Procedure Load
| NetPayableAmount |
NULL |
Received Claim Procedure Load
| NetPayableAmount |
|
||
InterestAmount
: numberInterest amount associated with the procedure
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| InterestAmount |
NULL |
CMS ACO Part A Procedure Files Load
| InterestAmount |
NULL |
CMS ACO Part B DME File Load
| InterestAmount |
NULL |
CMS ACO Part B Physicians File Load
| InterestAmount |
NULL |
CMS CJR DME Claim Procedure Load
| InterestAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| InterestAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| InterestAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| InterestAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| InterestAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| InterestAmount |
NULL |
CMS CJR Surgical Procedure Load
| InterestAmount |
NULL |
Data Aggregation ICD Procedure Load
| InterestAmount |
NULL |
Data Aggregation Service Line Load
| InterestAmount |
|
||||
|
If INTEREST_AMT_OVRD is not NULL then INTEREST_AMT_OVRD Otherwise INTEREST_AMT |
Externally Adjudicated ICD Procedure Load
| InterestAmount |
NULL |
Externally Adjudicated Service Line Load
| InterestAmount |
|
||||
|
If INTEREST_AMT_OVRD is not NULL then INTEREST_AMT_OVRD Otherwise INTEREST_AMT |
Payer System ICD Procedure Load
| InterestAmount |
NULL |
Payer System Service Line Load
| InterestAmount |
|
||||
|
If INTEREST_AMT_OVRD is not NULL then INTEREST_AMT_OVRD Otherwise INTEREST_AMT |
Received Claim ICD Procedure Load
| InterestAmount |
NULL |
Received Claim Procedure Load
| InterestAmount |
|
||||
|
If INTEREST_AMT_OVRD is not NULL then INTEREST_AMT_OVRD Otherwise INTEREST_AMT |
PenaltyAmount
: numberAmount paid in penalty associated with the procedure if the claim was paid late
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| PenaltyAmount |
NULL |
CMS ACO Part A Procedure Files Load
| PenaltyAmount |
NULL |
CMS ACO Part B DME File Load
| PenaltyAmount |
NULL |
CMS ACO Part B Physicians File Load
| PenaltyAmount |
NULL |
CMS CJR DME Claim Procedure Load
| PenaltyAmount |
CMS CJR Home Health Claim Procedure Load
| PenaltyAmount |
CMS CJR Inpatient Claim Procedure Load
| PenaltyAmount |
CMS CJR Outpatient Claim Procedure Load
| PenaltyAmount |
CMS CJR Part B Claim Procedure Load
| PenaltyAmount |
CMS CJR Skilled Nursing Claim Procedure Load
| PenaltyAmount |
CMS CJR Surgical Procedure Load
| PenaltyAmount |
Data Aggregation ICD Procedure Load
| PenaltyAmount |
NULL |
Data Aggregation Service Line Load
| PenaltyAmount |
|
||||
|
If AP_CLAIM_PROC_3.PENALTY_AMT_OVRD is not null then AP_CLAIM_PROC_3.PENALTY_AMT_OVRD Otherwise AP_CLAIM_PROC_3.PENALTY_AMT |
Externally Adjudicated ICD Procedure Load
| PenaltyAmount |
NULL |
Externally Adjudicated Service Line Load
| PenaltyAmount |
|
||||
|
If AP_CLAIM_PROC_3.PENALTY_AMT_OVRD is not null then AP_CLAIM_PROC_3.PENALTY_AMT_OVRD Otherwise AP_CLAIM_PROC_3.PENALTY_AMT |
Payer System ICD Procedure Load
| PenaltyAmount |
NULL |
Payer System Service Line Load
| PenaltyAmount |
|
||||
|
If AP_CLAIM_PROC_3.PENALTY_AMT_OVRD is not null then AP_CLAIM_PROC_3.PENALTY_AMT_OVRD Otherwise AP_CLAIM_PROC_3.PENALTY_AMT |
Received Claim ICD Procedure Load
| PenaltyAmount |
NULL |
Received Claim Procedure Load
| PenaltyAmount |
|
||||
|
If AP_CLAIM_PROC_3.PENALTY_AMT_OVRD is not null then AP_CLAIM_PROC_3.PENALTY_AMT_OVRD Otherwise AP_CLAIM_PROC_3.PENALTY_AMT |
CobPrimaryInsuranceAmount
: numberCoordination of benefits (COB) amount associated with the procedure already paid on the claim by primary insurance
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| CobPrimaryInsuranceAmount |
NULL |
CMS ACO Part A Procedure Files Load
| CobPrimaryInsuranceAmount |
NULL |
CMS ACO Part B DME File Load
| CobPrimaryInsuranceAmount |
NULL |
CMS ACO Part B Physicians File Load
| CobPrimaryInsuranceAmount |
NULL |
CMS CJR DME Claim Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
CMS CJR Surgical Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
Data Aggregation ICD Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
Data Aggregation Service Line Load
| CobPrimaryInsuranceAmount |
|
||
Externally Adjudicated ICD Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
Externally Adjudicated Service Line Load
| CobPrimaryInsuranceAmount |
|
||
Payer System ICD Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
Payer System Service Line Load
| CobPrimaryInsuranceAmount |
|
||
Received Claim ICD Procedure Load
| CobPrimaryInsuranceAmount |
NULL |
Received Claim Procedure Load
| CobPrimaryInsuranceAmount |
|
||
CobPrimaryInsurancePatientPortionAmount
: numberCoordination of benefits (COB) amount associated with the procedure the patient is responsible for paying as adjudicated by the primary insurance
Properties
- Data type
- number
- SQL Server data type
- numeric(18,2)
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
CMS ACO Part A Procedure Files Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
CMS ACO Part B DME File Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
CMS ACO Part B Physicians File Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR DME Claim Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Home Health Claim Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Inpatient Claim Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Outpatient Claim Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Part B Claim Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
CMS CJR Surgical Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
Data Aggregation ICD Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
Data Aggregation Service Line Load
| CobPrimaryInsurancePatientPortionAmount |
|
||
Externally Adjudicated ICD Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
Externally Adjudicated Service Line Load
| CobPrimaryInsurancePatientPortionAmount |
|
||
Payer System ICD Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
Payer System Service Line Load
| CobPrimaryInsurancePatientPortionAmount |
|
||
Received Claim ICD Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
NULL |
Received Claim Procedure Load
| CobPrimaryInsurancePatientPortionAmount |
|
||
ExternalClaim
: integer1/0 column that indicates whether the claim originated outside the organization. This column returns 1 if the claim originated outside the organization and 0 claim originated inside the organization.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| ExternalClaim |
NULL |
CMS ACO Part A Procedure Files Load
| ExternalClaim |
NULL |
CMS ACO Part B DME File Load
| ExternalClaim |
NULL |
CMS ACO Part B Physicians File Load
| ExternalClaim |
NULL |
CMS CJR DME Claim Procedure Load
| ExternalClaim |
NULL |
CMS CJR Home Health Claim Procedure Load
| ExternalClaim |
NULL |
CMS CJR Inpatient Claim Procedure Load
| ExternalClaim |
NULL |
CMS CJR Outpatient Claim Procedure Load
| ExternalClaim |
NULL |
CMS CJR Part B Claim Procedure Load
| ExternalClaim |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| ExternalClaim |
NULL |
CMS CJR Surgical Procedure Load
| ExternalClaim |
NULL |
Data Aggregation ICD Procedure Load
| ExternalClaim |
NULL |
Data Aggregation Service Line Load
| ExternalClaim |
NULL |
Externally Adjudicated ICD Procedure Load
| ExternalClaim |
NULL |
Externally Adjudicated Service Line Load
| ExternalClaim |
NULL |
Payer System ICD Procedure Load
| ExternalClaim |
NULL |
Payer System Service Line Load
| ExternalClaim |
NULL |
Received Claim ICD Procedure Load
| ExternalClaim |
NULL |
Received Claim Procedure Load
| ExternalClaim |
NULL |
IsCurrentInClaimProcedureSequence
: integer1/0 column that indicates that the procedure is a recent action within its adjustment sequence. If claim level adjustment sequences are used then a procedure will be current if its associated claim is not adjusted or reversed. If line level adjustment sequences are used then a procedure will be current if it is not adjusted or reversed.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsCurrentInClaimProcedureSequence |
NULL |
CMS ACO Part A Procedure Files Load
| IsCurrentInClaimProcedureSequence |
NULL |
CMS ACO Part B DME File Load
| IsCurrentInClaimProcedureSequence |
NULL |
CMS ACO Part B Physicians File Load
| IsCurrentInClaimProcedureSequence |
NULL |
CMS CJR DME Claim Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
CMS CJR Home Health Claim Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
CMS CJR Inpatient Claim Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
CMS CJR Outpatient Claim Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
CMS CJR Part B Claim Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
CMS CJR Surgical Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
Data Aggregation ICD Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
Data Aggregation Service Line Load
| IsCurrentInClaimProcedureSequence |
NULL |
Externally Adjudicated ICD Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
Externally Adjudicated Service Line Load
| IsCurrentInClaimProcedureSequence |
NULL |
Payer System ICD Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
Payer System Service Line Load
| IsCurrentInClaimProcedureSequence |
NULL |
Received Claim ICD Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
Received Claim Procedure Load
| IsCurrentInClaimProcedureSequence |
NULL |
IsFirstServiceLevelProcedure
: integer1/0 column that indicates whether the procedure is the first service-level procedure listed on the claim
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsFirstServiceLevelProcedure |
NULL |
CMS ACO Part A Procedure Files Load
| IsFirstServiceLevelProcedure |
NULL |
CMS ACO Part B DME File Load
| IsFirstServiceLevelProcedure |
NULL |
CMS ACO Part B Physicians File Load
| IsFirstServiceLevelProcedure |
NULL |
CMS CJR DME Claim Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
CMS CJR Home Health Claim Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
CMS CJR Inpatient Claim Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
CMS CJR Outpatient Claim Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
CMS CJR Part B Claim Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
CMS CJR Surgical Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
Data Aggregation ICD Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
Data Aggregation Service Line Load
| IsFirstServiceLevelProcedure |
NULL |
Externally Adjudicated ICD Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
Externally Adjudicated Service Line Load
| IsFirstServiceLevelProcedure |
|
||||
|
If LINE = 1 and no rows exist where TX_TYPE_C = 6 then 1 Otherwise if LINE = 2 and at least one row exists where TX_TYPE_C = 6 then 1 Otherwise 0 |
Payer System ICD Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
Payer System Service Line Load
| IsFirstServiceLevelProcedure |
NULL |
Received Claim ICD Procedure Load
| IsFirstServiceLevelProcedure |
NULL |
Received Claim Procedure Load
| IsFirstServiceLevelProcedure |
|
||||
|
If LINE = 1 and no rows exist where TX_TYPE_C = 6 then 1 Otherwise if LINE = 2 and at least one row exists where TX_TYPE_C = 6 then 1 Otherwise 0 |
IsValidClaimProcedureSequence
: integer1/0 column that indicates whether the claim procedure sequence is valid and that dollar amount summations across the sequence will balance out to what was truly paid. If 0 then you should only sum dollar amounts from the claim procedures in the sequence with IsCurrentInClaimProcedureSequence set to 1.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
- Default value
- 1
- Delete value
- 0
IsCapitated
: integer1/0 column that indicates whether or not a claim procedure was capitated. This column returns 1 if the procedure was capitated and 0 otherwise.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsCapitated |
NULL |
CMS ACO Part A Procedure Files Load
| IsCapitated |
NULL |
CMS ACO Part B DME File Load
| IsCapitated |
NULL |
CMS ACO Part B Physicians File Load
| IsCapitated |
NULL |
CMS CJR DME Claim Procedure Load
| IsCapitated |
NULL |
CMS CJR Home Health Claim Procedure Load
| IsCapitated |
NULL |
CMS CJR Inpatient Claim Procedure Load
| IsCapitated |
NULL |
CMS CJR Outpatient Claim Procedure Load
| IsCapitated |
NULL |
CMS CJR Part B Claim Procedure Load
| IsCapitated |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| IsCapitated |
NULL |
CMS CJR Surgical Procedure Load
| IsCapitated |
NULL |
Data Aggregation ICD Procedure Load
| IsCapitated |
NULL |
Data Aggregation Service Line Load
| IsCapitated |
|
||
|
If SYS_ADJUST_REASON_C = 1 - Procedure is capitated then 1 Otherwise 0 |
Externally Adjudicated ICD Procedure Load
| IsCapitated |
NULL |
Externally Adjudicated Service Line Load
| IsCapitated |
0 |
Payer System ICD Procedure Load
| IsCapitated |
NULL |
Payer System Service Line Load
| IsCapitated |
|
||
|
If SYS_ADJUST_REASON_C = 1 - Procedure is capitated then 1 Otherwise 0 |
Received Claim ICD Procedure Load
| IsCapitated |
NULL |
Received Claim Procedure Load
| IsCapitated |
|
||
|
If SYS_ADJUST_REASON_C = 1 - Procedure is capitated then 1 Otherwise 0 |
IsClinicallyValid
: integer1/0 column that indicates whether the clinical information on this claim can reliably be used. This column returns 1 if the clinical information on the claim can be used and 0 if the information is suspect or invalid. If this claim's associated ReceivedClaimKey's IdType is included in the 'IdTypes Excluded from IsClinicallyValid Automatic Calculation' configuration for ReceivedClaimFact, then this value is imported from source data. Otherwise this value is automatically set to 1 for claims that are not adjusted or cancelled by other claims and where the associated ReceivedClaimKey has IsClinicallyValid = 1.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsClinicallyValid |
|
||||||||||||
|
If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim and with the same PRVDR_OSCAR_NUM, CLM_FROM_DT, CLM_THRU_DT, and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0" |
CMS ACO Part A Procedure Files Load
| IsClinicallyValid |
|
||||||||||||
|
If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim and with the same PRVDR_OSCAR_NUM, CLM_FROM_DT, CLM_THRU_DT, and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0" |
CMS ACO Part B DME File Load
| IsClinicallyValid |
|
||||||||
|
If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim and with the same CLM_CNTL_NUM and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0" |
CMS ACO Part B Physicians File Load
| IsClinicallyValid |
|
||||||||
|
If the claim is the last claim in the sequence among claims with CLM_ADJSMT_TYPE_CD ≠1-Cancelation Claim and with the same CLM_CNTL_NUM and BENE_EQTBL_BIC_HICN_NUM then "1", otherwise "0" |
CMS CJR DME Claim Procedure Load
| IsClinicallyValid |
1 |
CMS CJR Home Health Claim Procedure Load
| IsClinicallyValid |
1 |
CMS CJR Inpatient Claim Procedure Load
| IsClinicallyValid |
1 |
CMS CJR Outpatient Claim Procedure Load
| IsClinicallyValid |
1 |
CMS CJR Part B Claim Procedure Load
| IsClinicallyValid |
1 |
CMS CJR Skilled Nursing Claim Procedure Load
| IsClinicallyValid |
1 |
CMS CJR Surgical Procedure Load
| IsClinicallyValid |
1 |
Data Aggregation ICD Procedure Load
| IsClinicallyValid |
|
||||||||||||||
|
If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1 |
Data Aggregation Service Line Load
| IsClinicallyValid |
|
||||||||||||||
|
If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1 |
Externally Adjudicated ICD Procedure Load
| IsClinicallyValid |
|
||||||||||||||
|
If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1 |
Externally Adjudicated Service Line Load
| IsClinicallyValid |
|
||||||||||||||
|
If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise 1 |
Payer System ICD Procedure Load
| IsClinicallyValid |
|
||||||||||||||
|
If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1 |
Payer System Service Line Load
| IsClinicallyValid |
|
||||||||||||||
|
If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1 |
Received Claim ICD Procedure Load
| IsClinicallyValid |
|
||||||||||||||
|
If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1 |
Received Claim Procedure Load
| IsClinicallyValid |
|
||||||||||||||
|
If CLM_FREQ_CODE_C = 8 - Cancel/Void Claim then 0 Otherwise if ADJST_CLM_ID is not null then 0 Otherwise if ORIG_REV_CLM_ID is not null then 0 Otherwise if there exists a claim where ORIG_REV_CLM_ID = CLAIM_ID then 0 Otherwise if IS_INVLD_ADJ_SEQ_YN = "Y" then 0 Otherwise if OVERRIDE_INVALID_YN = "N" then 1 Otherwise if OVERRIDE_INVALID_YN = "Y" then 0 Otherwise if INVALID_YN = "Y" then 0 Otherwise 1 |
IsHospitalOutpatientVisit
: integer1/0 column that indicates whether the claim procedure is part of an institutional outpatient visit. This column returns 1 if the claim procedure is part of an institutional outpatient visit and 0 otherwise.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 0
IsEmergencyDefiningClaimLine
: integer1/0 column that indicates whether the claim procedure is part of an emergency visit. This column returns 1 if the claim procedure is part of an emergency visit and 0 otherwise.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 0
IsOutpatientDefiningClaimLine
: integer1/0 column that indicates whether the claim is an outpatient claim. This column returns 1 if the claim is an outpatient claim and 0 otherwise. This column is used by algorithms to derive an outpatient encounter and is not intended to be used in a report. To report on claims derived outpatient encounters, use EncounterFact.IsOutpatientFaceToFaceVisit, EncounterFact.DerivedOutpatientVisitType, and EncounterFact.DerivedOutpatientVisitSubType instead.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 0
IsInterpretedClaimDetailTypeFromSourceData
: integer1/0 column that indicates whether the InterpretedClaimDetailType column contains a value assigned in the source data. This column returns 1 if the InterpretedClaimDetailType column contains a value assigned in the source and 0 if the InterpretedClaimDetailType column was derived.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
- Delete value
- 0
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
CMS ACO Part A Procedure Files Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
CMS ACO Part B DME File Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
CMS ACO Part B Physicians File Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
CMS CJR DME Claim Procedure Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
CMS CJR Home Health Claim Procedure Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
CMS CJR Inpatient Claim Procedure Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
CMS CJR Outpatient Claim Procedure Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
CMS CJR Part B Claim Procedure Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
CMS CJR Surgical Procedure Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
Externally Adjudicated ICD Procedure Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
Externally Adjudicated Service Line Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
Received Claim ICD Procedure Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
Received Claim Procedure Load
| IsInterpretedClaimDetailTypeFromSourceData |
NULL |
IsNonCclClaim
: integerFlag indicating if a claim has not been loaded via the Chronicles Claims Loader. This column will be set to 1 if not loaded via CCL or if the claim is deleted, 0 otherwise.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 1
- Delete value
- 1
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsNonCclClaim |
CMS ACO Part A Procedure Files Load
| IsNonCclClaim |
CMS ACO Part B DME File Load
| IsNonCclClaim |
CMS ACO Part B Physicians File Load
| IsNonCclClaim |
CMS CJR DME Claim Procedure Load
| IsNonCclClaim |
CMS CJR Home Health Claim Procedure Load
| IsNonCclClaim |
CMS CJR Inpatient Claim Procedure Load
| IsNonCclClaim |
CMS CJR Outpatient Claim Procedure Load
| IsNonCclClaim |
CMS CJR Part B Claim Procedure Load
| IsNonCclClaim |
CMS CJR Skilled Nursing Claim Procedure Load
| IsNonCclClaim |
CMS CJR Surgical Procedure Load
| IsNonCclClaim |
Externally Adjudicated ICD Procedure Load
| IsNonCclClaim |
Externally Adjudicated Service Line Load
| IsNonCclClaim |
Received Claim ICD Procedure Load
| IsNonCclClaim |
Received Claim Procedure Load
| IsNonCclClaim |
IsAuthorizationRequired
: integer1/0 column that indicates whether authorization is required for this service. This column returns 1 if authorization is required, and 0 if it is not required.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| IsAuthorizationRequired |
NULL |
CMS ACO Part A Procedure Files Load
| IsAuthorizationRequired |
NULL |
CMS ACO Part B DME File Load
| IsAuthorizationRequired |
NULL |
CMS ACO Part B Physicians File Load
| IsAuthorizationRequired |
NULL |
CMS CJR DME Claim Procedure Load
| IsAuthorizationRequired |
NULL |
CMS CJR Home Health Claim Procedure Load
| IsAuthorizationRequired |
NULL |
CMS CJR Inpatient Claim Procedure Load
| IsAuthorizationRequired |
NULL |
CMS CJR Outpatient Claim Procedure Load
| IsAuthorizationRequired |
NULL |
CMS CJR Part B Claim Procedure Load
| IsAuthorizationRequired |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| IsAuthorizationRequired |
NULL |
CMS CJR Surgical Procedure Load
| IsAuthorizationRequired |
NULL |
Data Aggregation ICD Procedure Load
| IsAuthorizationRequired |
NULL |
Data Aggregation Service Line Load
| IsAuthorizationRequired |
NULL |
Externally Adjudicated ICD Procedure Load
| IsAuthorizationRequired |
NULL |
Externally Adjudicated Service Line Load
| IsAuthorizationRequired |
NULL |
Payer System ICD Procedure Load
| IsAuthorizationRequired |
Payer System Service Line Load
| IsAuthorizationRequired |
Received Claim ICD Procedure Load
| IsAuthorizationRequired |
NULL |
Received Claim Procedure Load
| IsAuthorizationRequired |
|
||
|
If AUTH_REQ_YN = "Y" then 1 If AUTH_REQ_YN = "N" then 0 Otherwise NULL |
HasSuggestedAuthorization
: integer1/0 column that indicates whether an authorization was identified as a suggested match for this service. This column returns 1 if a suggested match was found and 0 if one was not found.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
Data Lineage for Each Package
CMS ACO Part A Files Load
| HasSuggestedAuthorization |
NULL |
CMS ACO Part A Procedure Files Load
| HasSuggestedAuthorization |
NULL |
CMS ACO Part B DME File Load
| HasSuggestedAuthorization |
NULL |
CMS ACO Part B Physicians File Load
| HasSuggestedAuthorization |
NULL |
CMS CJR DME Claim Procedure Load
| HasSuggestedAuthorization |
NULL |
CMS CJR Home Health Claim Procedure Load
| HasSuggestedAuthorization |
NULL |
CMS CJR Inpatient Claim Procedure Load
| HasSuggestedAuthorization |
NULL |
CMS CJR Outpatient Claim Procedure Load
| HasSuggestedAuthorization |
NULL |
CMS CJR Part B Claim Procedure Load
| HasSuggestedAuthorization |
NULL |
CMS CJR Skilled Nursing Claim Procedure Load
| HasSuggestedAuthorization |
NULL |
CMS CJR Surgical Procedure Load
| HasSuggestedAuthorization |
NULL |
Data Aggregation ICD Procedure Load
| HasSuggestedAuthorization |
NULL |
Data Aggregation Service Line Load
| HasSuggestedAuthorization |
NULL |
Externally Adjudicated ICD Procedure Load
| HasSuggestedAuthorization |
NULL |
Externally Adjudicated Service Line Load
| HasSuggestedAuthorization |
NULL |
Payer System ICD Procedure Load
| HasSuggestedAuthorization |
Payer System Service Line Load
| HasSuggestedAuthorization |
Received Claim ICD Procedure Load
| HasSuggestedAuthorization |
NULL |
Received Claim Procedure Load
| HasSuggestedAuthorization |
|
||
|
If POTENTIAL_AUTH_FOUND = "Y" then 1 If POTENTIAL_AUTH_FOUND = "N" then 0 Otherwise NULL |
Count
: integerArtificial measure on which calculations can be done. The value is 0 for rows marked as deleted, 1 otherwise.
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 1
- Delete value
- 0
_CreationInstant
: date/timeThe date and time the record was created
Properties
- Data type
- date/time
- SQL Server data type
- datetime
- Allows null
- Yes
_LastUpdatedInstant
: date/timeThe date and time the record was last updated
Properties
- Data type
- date/time
- SQL Server data type
- datetime
- Allows null
- Yes
_IsInferred
: integer1/0 column that indicates whether the record is inferred
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
- Default value
- 0
_IsDeleted
: integer1/0 column that indicates whether the record is deleted
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- Yes
- Default value
- 0
_PrimaryPackageToImpactRecord
: stringThe name of the primary package to impact the record
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- empty string
_MostRecentPackageToImpactRecord
: stringThe name of the most recent package to impact the record
Properties
- Data type
- string
- SQL Server data type
- nvarchar(50)
- Allows null
- No
- Default value
- *Unknown
- Delete value
- empty string
_NumberOfSources
: integerThe number of sources contributing to the record
Properties
- Data type
- integer
- SQL Server data type
- smallint
- Allows null
- No
- Default value
- 0
_HasSourceClarity
: integer1/0 column that indicates whether the record is influenced by the Clarity source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
_DeletedFromSourceClarity
: integer1/0 column that indicates whether the record is deleted from the Clarity source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
_HasSourceCmsAco
: integer1/0 column that indicates whether the record is influenced by the CMS ACO source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
_DeletedFromSourceCmsAco
: integer1/0 column that indicates whether the record is deleted from the CMS ACO source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
_HasSourceCmsCjr
: integer1/0 column that indicates whether the record is influenced by the CMS CJR source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0
_DeletedFromSourceCmsCjr
: integer1/0 column that indicates whether the record is deleted from the CMS CJR source
Properties
- Data type
- integer
- SQL Server data type
- tinyint
- Allows null
- No
- Default value
- 0